Trends in transcatheter and operative closure of patent ductus arteriosus in neonatal intensive care units: Analysis of data from the Pediatric Health Information Systems Database

O’Byrne, Michael L.; Millenson, Marisa E.; Grady, Connor B.; Huang, Jing; Bamat, Nicolas A.; Munson, David; Song, Lihai; Dori, Yoav; Gillespie, Matthew J.; Rome, Jonathan J.; Glatz, Andrew C.

doi:10.1016/j.ahj.2019.08.009

Cited by 23 publications

(13 citation statements)

References 42 publications

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“… 14 Newer technologies have allowed TC to be safely performed even in extremely low‐birth‐weight premature infants as small as 700 g. 15 , 16 The proportion of PDA closures performed by TC relative to SL is increasing. 11 , 17 Recent work has shown improved outcomes with TC, including decreased IVH, 18 decreased inotrope use, 18 and shorter duration of mechanical ventilation. 19 , 20 Small studies have shown higher procedural charges for TC compared with SL; however, the benefits in terms of reducing procedure duration are less clear.…”

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confidence: 99%

Trend and Outcomes for Surgical Versus Transcatheter Patent Ductus Arteriosus Closure in Neonates and Infants at US Children’s Hospitals

Kuntz

Staffa

Faraoni

et al. 2022

JAHA

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Background Pharmacologic therapy for patent ductus arteriosus closure is not consistently successful. Surgical ligation (SL) or transcatheter closure (TC) may be needed. Large multicenter analyses comparing outcomes and resource use between SL and TC are lacking. We hypothesized that patients undergoing TC have improved outcomes compared with SL, including mortality, hospital and intensive care unit length of stay, and mechanical ventilation. Methods and Results Using the 2016 to 2020 Pediatric Health Information System database, characteristics, outcomes, and charges of patients aged <1 year who underwent TC or SL were analyzed. A total of 678 inpatients undergoing TC (n=503) or SL (n=175) were identified. Surgical patients were younger (0.1 versus 0.53 years; P <0.001) and more premature (60% versus 20.3%; P <0.001). Surgical patients had higher mortality (1.7% versus 0%; P =0.02). Using inverse probability of treatment weighting by the propensity score, multivariable‐adjusted analyses demonstrated favorable outcomes in TC: intensive care unit admission rates (adjusted odds ratio [OR], 0.2; 95% CI, 0.11–0.32; P <0.001); mechanical ventilation rates (adjusted OR, 0.3; 95% CI, 0.19–0.56; P <0.001); and shorter hospital (adjusted coefficient, 2 days shorter; 95% CI, 1.3–2.7; P <0.001) and postoperative (adjusted coefficient, 1.2 days shorter; 95% CI, 0.1–2.3; P =0.039) stays. Overall charges and readmission rates were similar. Among premature neonates and infants, hospital (adjusted difference in medians, 4 days; 95% CI, 1.7–6.3 days; P <0.001) and postoperative stays (adjusted difference in medians, 3 days; 95% CI, 1.1–4.9 days; P =0.002) were longer for SL. Conclusions TC is associated with lower mortality and reduced length of stay compared with SL. Rates of TC continue to increase compared with SL.

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confidence: 99%

Trend and Outcomes for Surgical Versus Transcatheter Patent Ductus Arteriosus Closure in Neonates and Infants at US Children’s Hospitals

Kuntz

Staffa

Faraoni

et al. 2022

JAHA

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“…In the process of its secretion or entering the blood circulation, BNP will be divided into biologically active BNP and non-biologically active acid B-type natriuretic peptide precursor (NT-pro-BNP) by proteolytic enzymes. There is a close relationship between the two, which can reflect the body's pulmonary blood volume and left ventricular load (7,8). Under normal physiological conditions, a small amount of BNP can be detected in the blood circulation.…”

Section: Discussionmentioning

confidence: 99%

Change and clinical significance of serum cortisol, BNP, and PGE-2 levels in premature infants with patent ductus arteriosus

Cui

Liu

et al. 2021

Transl Pediatr

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Background:To analyze the change and clinical significance of cortisol, B-type brain natriuretic peptide (BNP), and prostacyclin-2 (PGE-2) levels in premature infants with patent ductus arteriosus (PDA).Methods: A total of 67 cases of premature infants admitted to our hospital from January 2018 to April 2020 were included, all of whom developed PDA (PDA group). According to the presence or absence of symptoms, they were divided into the symptomatic group (28 cases) and the asymptomatic group (39 cases).In addition, 62 premature infants without PDA who were born in our hospital during the same period were selected as the control group. The expression levels of cortisol, BNP, and PGE-2 in infants in different groups and between infants with symptoms and without symptoms were analyzed, along with the risk factors leading to PDA in preterm infants. The value of cortisol, BNP, and PGE-2 in the diagnosis of PDA in premature infants was also analyzed.Results: Compared with the control group, cortisol in the PDA group was significantly decreased (P<0.05), while the levels of BNP and PGE-2 were significantly increased (P<0.05). The cortisol level in the asymptomatic group was significantly higher than that in the symptomatic group, while the levels of BNP and PGE-2 were opposite, and the differences were statistically significant (P<0.05). Logistic regression analysis showed that birth weight <1,200 g, decreased cortisol, increased BNP, and increased PGE-2 were independent risk factors leading to PDA in preterm infants, and the differences were statistically significant (P<0.05). Receiver operating characteristic (ROC) curve showed that the sensitivity and specificity of cortisol+BNP+PGE-2 in the diagnosis of PDA in premature infants were 75.60% and 73.10%, respectively.The area under the curve (AUC) value was 0.759 (95% CI: 0.611-0.859), which was significantly higher than the AUC values of the 3 tests alone (P<0.05). Conclusions:The expression of cortisol decreased in premature infants with PDA, while the levels of BNP and PGE-2 significantly increased. Dynamic detection of the changes in these levels can provide an important reference for the early diagnosis of PDA and for the assessment of disease progression.

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“…It was not thought that either variable could be imputed from other data so these subjects were given a ''missing'' classification to avoid bias as described previously. 24,[28][29][30][31][32] The threshold for significance was set at p < 0.05. Primary and secondary outcomes were established prior to analysis, and no adjustment for multiple comparisons was made.…”

Section: Discussionmentioning

confidence: 99%

“…Census region was also missing at a lower rate (<5% for each subcategory). It was not thought that either variable could be imputed from other data so these subjects were given a “missing” classification to avoid bias as described previously 24 , 28–32 . The threshold for significance was set at p < 0.05.…”

Section: Methodsmentioning

confidence: 99%

Variation in the use of pulmonary vasodilators in children and adolescents with pulmonary hypertension: a study using data from the MarketScan® insurance claims database

et al. 2020

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Trends in transcatheter and operative closure of patent ductus arteriosus in neonatal intensive care units: Analysis of data from the Pediatric Health Information Systems Database

Cited by 23 publications

References 42 publications

Trend and Outcomes for Surgical Versus Transcatheter Patent Ductus Arteriosus Closure in Neonates and Infants at US Children’s Hospitals

Trend and Outcomes for Surgical Versus Transcatheter Patent Ductus Arteriosus Closure in Neonates and Infants at US Children’s Hospitals

Change and clinical significance of serum cortisol, BNP, and PGE-2 levels in premature infants with patent ductus arteriosus

Variation in the use of pulmonary vasodilators in children and adolescents with pulmonary hypertension: a study using data from the MarketScan® insurance claims database

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