Skip to main content
Erschienen in: Pediatric Cardiology 2/2020

08.11.2019 | Original Article

Invasive Cardiac Procedures in Interstage Single Ventricle Patients in Emergent Hospitalizations

verfasst von: Brena S. Haughey, Shelby C. White, Garrett S. Pacheco, Kenneth A. Fox, Michael D. Seckeler

Erschienen in: Pediatric Cardiology | Ausgabe 2/2020

Einloggen, um Zugang zu erhalten

Abstract

Single ventricle congenital heart disease (SV CHD) patients are at risk of morbidity and mortality between the first and second palliative surgical procedures (interstage). When these patients present acutely they often require invasive intervention. This study sought to compare the outcomes and costs of elective and emergent invasive cardiac procedures for interstage patients. Retrospective review of discharge data from The Vizient Clinical Data Base/Resource Manager™, a national health care analytics platform. The database was queried for admissions from 10/2014 to 12/2017 for children 1–6 months old with ICD-9 or ICD-10 codes for SV CHD who underwent invasive cardiac procedures. Demographics, length of stay (LOS), complication rate, in-hospital mortality and direct costs were compared between elective and emergent admissions using t test or χ2, as appropriate. The three most frequently performed procedures were also compared. 871 admissions identified, with 141 (16%) emergent. Age of emergent admission was younger than elective (2.9 vs. 4 months p < 0.001). Emergent admissions including cardiac catheterization or superior cavo-pulmonary anastomosis had longer LOS (58.7 vs. 25.8 day, p < 0.001 and 54.8 vs .22.6 days, p < 0.001) and higher costs ($134,774 vs. $84,253, p = 0.013 and $158,679 vs. $81,899, p = 0.017). Emergent admissions for interstage SV CHD patients undergoing cardiac catheterization or superior cavo-pulmonary anastomosis are associated with longer LOS and higher direct costs, but with no differences in complications or mortality. These findings support aggressive interstage monitoring to minimize the need for emergent interventions for this fragile patient population.
Literatur
1.
Zurück zum Zitat Hoffman JI, Kaplan S (2002) The incidence of congenital heart disease. J Am Coll Cardiol 39:1890–1900CrossRef Hoffman JI, Kaplan S (2002) The incidence of congenital heart disease. J Am Coll Cardiol 39:1890–1900CrossRef
2.
Zurück zum Zitat Bates KE, Yu S, Lowery R, Pasquali SK, Brown DW, Manning PB, Uzark K (2018) Examining variation in interstage mortality rates across the National Pediatric Cardiology Quality Improvement Collaborative: do lower-mortality centres have lower-risk patients? Cardiol Young 28:1031–1036CrossRef Bates KE, Yu S, Lowery R, Pasquali SK, Brown DW, Manning PB, Uzark K (2018) Examining variation in interstage mortality rates across the National Pediatric Cardiology Quality Improvement Collaborative: do lower-mortality centres have lower-risk patients? Cardiol Young 28:1031–1036CrossRef
3.
Zurück zum Zitat Bingler M, Erickson LA, Reid KJ, Lee B, O’Brien J, Apperson J, Goggin K, Shirali G (2018) Interstage outcomes in infants with single ventricle heart disease comparing home monitoring technology to three-ring binder documentation: a randomized crossover study. World J Pediatr Congenit Heart Surg. 9:305–314CrossRef Bingler M, Erickson LA, Reid KJ, Lee B, O’Brien J, Apperson J, Goggin K, Shirali G (2018) Interstage outcomes in infants with single ventricle heart disease comparing home monitoring technology to three-ring binder documentation: a randomized crossover study. World J Pediatr Congenit Heart Surg. 9:305–314CrossRef
4.
Zurück zum Zitat Knirsh W, Bertholdt S, Stoffel G, Stiasny B, Weber R, Dave H, Prêtre R, von Rhein M, Kretschmar O (2014) Clinical course and interstage monitoring after the Norwood and hybrid procedures for hypoplastic left heart syndrome. Pediatr Cardiol 35:851–856CrossRef Knirsh W, Bertholdt S, Stoffel G, Stiasny B, Weber R, Dave H, Prêtre R, von Rhein M, Kretschmar O (2014) Clinical course and interstage monitoring after the Norwood and hybrid procedures for hypoplastic left heart syndrome. Pediatr Cardiol 35:851–856CrossRef
5.
6.
Zurück zum Zitat Hurst DM, Oster ME, Smith S, Clabby ML (2015) Is clinic visit frequency associated with weight gain during the interstage period? A report from the Joint Council on congenital heart disease national pediatric cardiology quality improvement collaborative (JCCHD-NPCQIC). Pediatr Cardiol 36(7):1382–1385. https://doi.org/10.1007/s00246-015-1169-6 CrossRefPubMed Hurst DM, Oster ME, Smith S, Clabby ML (2015) Is clinic visit frequency associated with weight gain during the interstage period? A report from the Joint Council on congenital heart disease national pediatric cardiology quality improvement collaborative (JCCHD-NPCQIC). Pediatr Cardiol 36(7):1382–1385. https://​doi.​org/​10.​1007/​s00246-015-1169-6 CrossRefPubMed
7.
Zurück zum Zitat Evans CF, Sorkin JD, Abraham DS, Wehman B, Kaushal S, Rosenthal GL (2017) Interstage weight gain is associated with survival after first-stage single-ventricle palliation. Ann Thorac Surg 104:674–680CrossRef Evans CF, Sorkin JD, Abraham DS, Wehman B, Kaushal S, Rosenthal GL (2017) Interstage weight gain is associated with survival after first-stage single-ventricle palliation. Ann Thorac Surg 104:674–680CrossRef
8.
Zurück zum Zitat Hill GD, Rudd NA, Ghanayem NS, Hehir DA, Bartz PJ (2016) Center variability in timing of stage 2 palliation and association with interstage mortality: a report from the National Pediatric Cardiology Quality Improvement Collaborative. Pediatr Cardiol. 37:1516–1524CrossRef Hill GD, Rudd NA, Ghanayem NS, Hehir DA, Bartz PJ (2016) Center variability in timing of stage 2 palliation and association with interstage mortality: a report from the National Pediatric Cardiology Quality Improvement Collaborative. Pediatr Cardiol. 37:1516–1524CrossRef
9.
Zurück zum Zitat Frohnert BK, Lussky RC, Alms MA, Mendelsohn NJ, Symonik DM, Falken MC (2005) Validity of hospital discharge data for identifying infants with cardiac defects. J Perinatol 25:737–742CrossRef Frohnert BK, Lussky RC, Alms MA, Mendelsohn NJ, Symonik DM, Falken MC (2005) Validity of hospital discharge data for identifying infants with cardiac defects. J Perinatol 25:737–742CrossRef
Metadaten
Titel
Invasive Cardiac Procedures in Interstage Single Ventricle Patients in Emergent Hospitalizations
verfasst von
Brena S. Haughey
Shelby C. White
Garrett S. Pacheco
Kenneth A. Fox
Michael D. Seckeler
Publikationsdatum
08.11.2019
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 2/2020
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-019-02247-4

Weitere Artikel der Ausgabe 2/2020

Pediatric Cardiology 2/2020 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.