Tracheostomy in Infants With Congenital Heart Disease: A Nationwide Population-Based Study in Taiwan

Population‐based study of congenital heart disease and revisits after pediatric tonsillectomy

“…In line with these studies, our analytic sample included a population of relatively older children, with a median age of 6 years. Meanwhile, the association of CHD with revisit risk appears strongest in studies that focus on younger children …”

“…Because the SID and SASD do not explicitly specify whether CHD has been corrected, correction status was not included in the classification scheme. Based on past literature, we controlled for other comorbidities listed among the discharge diagnosis codes for the surgical encounter, including obstructive sleep apnea (ICD‐9 327.23), chromosomal anomaly (ICD‐9 758), congenital airway anomaly (ICD‐9 748), and neuromuscular impairment (ICD‐9 318, 330, 334, 335, 343, 359, 740‐742, 754‐756) …”

“…These models included a hospital‐level random intercept effect to account for the clustering of patients within hospitals. Covariates included the following characteristics at the time of surgery: age (0–3, 4–9, or 10–17), gender, insurance status (public, private, or other), ambulatory procedure, the facility location (state and whether the facility was in a rural or urban area), year of surgery, surgery type (tonsillectomy alone vs. tonsillectomy and adenoidectomy), national median household income quartile of the patient's ZIP code of residence, and the comorbidities listed above . As a secondary analysis, we stratified patients according to inpatient status and evaluated the risk of an unplanned hospital revisit within these subpopulations using multivariable mixed effects logistic regression.…”

“…Although serious perioperative adverse events related to CHD have been reported, the independent association of CHD with post‐discharge outcomes remains unclear. Studies of a variety of surgical procedures performed primarily in infants and young children have generally found CHD to be associated with a greater risk of adverse postsurgical outcomes, such as increased risk of readmissions or prolonged postoperative stay . One previous study has described an increased risk of respiratory complications after T/A in children with CHD .…”

“…Studies of a variety of surgical procedures performed primarily in infants and young children have generally found CHD to be associated with a greater risk of adverse postsurgical outcomes, such as increased risk of readmissions or prolonged postoperative stay. [2][3][4][5][6][7][8][9][10][11] One previous study has described an increased risk of respiratory complications after T/A in children with CHD. 12 Yet, studies of procedures performed primarily in older children (eg, posterior spinal fusion) have typically found no association between CHD and postoperative outcomes.…”