Congenital heart diseaseStaged Palliation of Hypoplastic Left Heart Syndrome: Trends in Mortality, Cost, and Length of Stay Using a National Database from 2000 Through 2009
Section snippets
Methods
This study was a retrospective, observational data analysis over a 10-year period from 2000 to 2009. This study was performed in accordance with the institutional review board at Cincinnati Children's Hospital Medical Center (IRB# 2011-1926).
The 2000, 2003, 2006, and 2009 KID data were used. The KID, developed by HCUP, which was sponsored by the Agency for Healthcare Research and Quality, was designed to analyze inpatient visits for children aged ≤20 years in the United States and has been used
Results
There were 16,923 admissions for patients with HLHS for the 2000, 2003, 2006, and 2009 time points of which 5,672 (34%) were admissions for staged surgical palliation (Table 1). From 2000 through 2009, there was an increasing number of total HLHS admissions as well as admissions with associated staged surgical palliations. Comparing surgical admissions by stage type, there was a decrease in the percent of admissions for stage I palliation, from 62% in 2000 to 48% in 2009, with a corresponding
Discussion
This study demonstrated a national trend of decreasing HLHS in-hospital mortality that is concurrent with increases in total admissions, surgical admission, and LOS. These changes occurred temporally with stabilization, if not reduction, in the associated per-patient cost burden. The results offer a broad perspective on the direction of care for HLHS in the United States between 2000 and 2009. Such insights on HLHS care are important and complementary to the knowledge gained through efforts
Disclosures
The authors have no conflicts of interest to disclose.
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Cited by (34)
Echocardiographic assessment of ventricular function: Conventional and advanced technologies and their clinical applications
2020, Progress in Pediatric CardiologyCitation Excerpt :Peak exercise capacity is generally decreased (approximately 60% of normal) in Fontan patients [67]. Although the development of the staged surgical palliation has improved life expectancy, patients with single ventricle are still at risk for progressive heart failure and death [68], especially in patients with single RV as RV is morphologically not capable of dealing with chronic exposure to the high afterload of the systemic circulation [69]. Although ventricular systolic function was overall preserved in most of the pediatric patients after Fontan operation [70], many of these patients with functional single RV due to hypoplastic left heart syndrome develop ventricular mechanical dyssynchrony, likely contributing to their RV dysfunction [71].
Selective Use of Inpatient Interstage Management After Norwood Procedure
2020, Annals of Thoracic SurgeryHealth Care Resource Utilization Among Children With Congenital Heart Disease: A Population-Based Study
2018, Canadian Journal of CardiologyCitation Excerpt :In Canada, hospitalizations and associated costs among children with CHD have been increasing over time (although to a lesser extent compared with the adult with CHD), with complex CHD lesions accounting for the majority of inpatient resource utilization.10,16 Therefore, improving survival of children with SV1 is anticipated to further increase HRU in this subgroup. This study provides a better understating of the resource utilization among children with CHD during early childhood in the context of a government-funded, universal health care system.
Genetics of hypoplastic left heart syndrome
2016, Journal of PediatricsCitation Excerpt :The Single Ventricle Reconstruction Trial sponsored by the Pediatric Heart Network demonstrated that the poor neurodevelopmental outcomes were associated more with innate patient factors than intraoperative management.13 In addition to the surgical interventions, survivors with HLHS face long-term health care burden and comorbid conditions resulting in high health care resource utilization.14-16 It is noteworthy that the delineation of the extended natural history of HLHS has just begun as the current surgical intervention was first implemented in the 1980s.
Resource utilization for noncardiac admissions in pediatric patients with single ventricle disease
2016, American Journal of CardiologyCitation Excerpt :Characterization and recognition of how hospital resources are used has become an increasingly important aspect of patient management as health care costs have dramatically increased in recent decades. Even with, or perhaps because of, advancements in surgical techniques, costs of staged SV palliation have continued to increase.17 It is prudent, therefore, to understand the reasons why resources are used so steps can be taken to decrease the factors that lead to increased costs.
Variation in hospital costs and resource utilisation after congenital heart surgery
2023, Cardiology in the Young
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