Trends in Discharge Prescription of Digoxin After Norwood Operation: An Analysis of Data from the Pediatric Health Information System (PHIS) Database

O’Byrne, Michael L.; Song, Lihai; Huang, Jing; Goldberg, David J.; Gardner, Monique M.; Ravishankar, Chitra; Rome, Jonathan J.; Glatz, Andrew C.

doi:10.1007/s00246-021-02543-y

Cited by 9 publications

(3 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As in prior studies, centers with very low procedural volumes, in this case fewer than an annual average of 4 total procedures (DAS and BTTS) per year over the study period, were excluded. 21 , 22 …”

Section: Methodsmentioning

confidence: 99%

“…The MOR quantifies the variation between centers (clusters) and is subject to the same assumptions of normality, homoscedasticity, and independence as mixed effects models. 22 , 25 , 26 When 2 subjects with the same covariates are randomly selected from 2 different clusters, the MOR is the odds ratio between the subject with higher propensity for the outcome and the subject with lower propensity for the outcome, and interpretation is directly comparable to fixed‐effects ORs. The MOR is by definition ≥1, and an MOR of 1.0 means no intercluster variation.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Trends in Ductus Arteriosus Stent Versus Blalock‐Taussig‐Thomas Shunt Use and Comparison of Cost, Length of Stay, and Short‐Term Outcomes in Neonates With Ductal‐Dependent Pulmonary Blood Flow: An Observational Study Using the Pediatric Health Information Systems Database

Lemley,

Wu,

Roberts

et al. 2023

JAHA

Self Cite

View full text Add to dashboard Cite

Background The modified Blalock‐Taussig‐Thomas shunt is the gold standard palliation for securing pulmonary blood flow in infants with ductal‐dependent pulmonary blood flow. Recently, the ductus arteriosus stent (DAS) has become a viable alternative. Methods and Results This was a retrospective multicenter study of neonates ≤30 days undergoing DAS or Blalock‐Taussig‐Thomas shunt placement between January 1, 2017 and December 31, 2020 at hospitals reporting to the Pediatric Health Information Systems database. We performed generalized linear mixed‐effects modeling to evaluate trends in intervention and intercenter variation, propensity score adjustment and inverse probability weighting with linear mixed‐effects modeling to analyze length of stay and cost of hospitalization, and generalized linear mixed modeling to analyze differences in 30‐day outcomes. There were 1874 subjects (58% male, 61% White) from 45 centers (29% DAS). Odds of DAS increased with time (odds ratio [OR] 1.23, annually, P <0.01 [95% CI, 1.10–1.38]) with significant intercenter variation (median OR, 3.81 [95% CI, 2.74–5.91]). DAS was associated with shorter hospital length of stay (ratio of geometric means, 0.76 [95% CI, 0.63–0.91]), shorter intensive care unit length of stay (ratio of geometric means, 0.77 [95% CI, 0.61–0.97]), and less expensive hospitalization (ratio of geometric means, 0.70 [95% CI, 0.56–0.87]). Intervention was not significantly associated with odds of 30‐day transplant‐free survival (OR,1.18 [95% CI, 0.70–1.99]) or freedom from catheter reintervention (OR, 1.02 [95% CI, 0.65–1.58]), but DAS was associated with 30‐day freedom from composite adverse outcome (OR, 1.51 [95% CI, 1.11–2.05]). Conclusions Use of DAS is increasing, but there is variability across centers. Though odds of transplant‐free survival and reintervention were not significantly different after DAS, and DAS was associated with shorter length of stay and lower in‐hospital costs.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Trends in Ductus Arteriosus Stent Versus Blalock‐Taussig‐Thomas Shunt Use and Comparison of Cost, Length of Stay, and Short‐Term Outcomes in Neonates With Ductal‐Dependent Pulmonary Blood Flow: An Observational Study Using the Pediatric Health Information Systems Database

Lemley,

Wu,

Roberts

et al. 2023

JAHA

Self Cite

View full text Add to dashboard Cite

show abstract

“… 6 , 7 Likely influenced by these studies, there has been a notable increase in the use of digoxin in the interstage period, though there remains a high degree of center practice variability. 8 , 9 , 10 …”

mentioning

confidence: 99%

Association of Digoxin Use With Transplant‐Free Interstage Survival in Infants Palliated With a Stage 1 Hybrid Procedure

Reddy,

Zyblewski,

Chowdhury

et al. 2023

JAHA

View full text Add to dashboard Cite

Background Digoxin prescription in patients with single‐ventricle physiology after stage 1 palliation is associated with reduced interstage death. Prior literature has primarily included patients having undergone the Norwood procedure. We sought to determine if digoxin prescription at discharge in infants following hybrid stage 1 palliation was associated with improved transplant‐free interstage survival. Methods and Results A retrospective multicenter cohort analysis was conducted using data from the National Pediatric Cardiology Quality Improvement Collaborative registry data from 2008 to 2021. Infants with functional single ventricles and aortic arch obstruction discharged home after the hybrid stage 1 palliation hospitalization were included. Patients were excluded if they had supraventricular tachycardia or conversion to Norwood operation. The primary outcome was transplant‐free survival. Multivariable logistic regression analysis including a propensity score for digoxin use identified associations between digoxin use and interstage death or transplant. Of 259 included infants from 45 sites, 158 (61%) had hypoplastic left heart syndrome. Forty‐nine percent had a gestational age ≤38 weeks, 18% had a birth weight <2.5 kg, and 58% had a preoperative risk factor. Of the 259 subjects, 129 (50%) were discharged on digoxin. Interstage death or transplant occurred in 30 (23%) patients in the no‐digoxin group compared with 18 (14%) in the digoxin group ( P =0.06). With multivariate analysis, discharge digoxin prescription was associated with a lower risk of interstage death or transplant (adjusted odds ratio, 0.48 [95% CI, 0.24–0.93]; P =0.03). Conclusions In infants with single‐ventricle physiology who underwent hybrid stage 1 palliation, digoxin prescription at hospital discharge was associated with improved interstage transplant‐free survival.

show abstract

Prevalent pharmacotherapy of US Fontan survivors: A study utilizing data from the MarketScan Commercial and Medicaid claims databases

O’Byrne

Faerber

Katcoff

et al. 2022

American Heart Journal

View full text Add to dashboard Cite

Trends in Discharge Prescription of Digoxin After Norwood Operation: An Analysis of Data from the Pediatric Health Information System (PHIS) Database

Cited by 9 publications

References 48 publications

Trends in Ductus Arteriosus Stent Versus Blalock‐Taussig‐Thomas Shunt Use and Comparison of Cost, Length of Stay, and Short‐Term Outcomes in Neonates With Ductal‐Dependent Pulmonary Blood Flow: An Observational Study Using the Pediatric Health Information Systems Database

Trends in Ductus Arteriosus Stent Versus Blalock‐Taussig‐Thomas Shunt Use and Comparison of Cost, Length of Stay, and Short‐Term Outcomes in Neonates With Ductal‐Dependent Pulmonary Blood Flow: An Observational Study Using the Pediatric Health Information Systems Database

Association of Digoxin Use With Transplant‐Free Interstage Survival in Infants Palliated With a Stage 1 Hybrid Procedure

Prevalent pharmacotherapy of US Fontan survivors: A study utilizing data from the MarketScan Commercial and Medicaid claims databases

Contact Info

Product

Resources

About