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Erschienen in: Pediatric Cardiology 4/2021

03.02.2021 | Original Article

Timing of Transfer and Mortality in Neonates with Hypoplastic Left Heart Syndrome in California

verfasst von: Neha J. Purkey, Chen Ma, Henry C. Lee, Susan R. Hintz, Gary M. Shaw, Doff B. McElhinney, Suzan L. Carmichael

Erschienen in: Pediatric Cardiology | Ausgabe 4/2021

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Abstract

Maternal race/ethnicity is associated with mortality in neonates with hypoplastic left heart syndrome (HLHS). We investigated whether maternal race/ethnicity and other sociodemographic factors affect timing of transfer after birth and whether timing of transfer impacts mortality in infants with HLHS. We linked two statewide databases, the California Perinatal Quality Care Collaborative and records from the Office of Statewide Health Planning and Development, to identify cases of HLHS born between 1/1/06 and 12/31/11. Cases were divided into three groups: birth at destination hospital, transfer on day of life 0–1 (“early transfer”), or transfer on day of life ≥ 2 (“late transfer”). We used log-binomial regression models to estimate relative risks (RR) for timing of transfer and Cox proportional hazard models to estimate hazard ratios (HR) for mortality. We excluded infants who died within 60 days of life without intervention from the main analyses of timing of transfer, since intervention may not have been planned in these infants. Of 556 cases, 107 died without intervention (19%) and another 52 (9%) died within 28 days. Of the 449 included in analyses of timing of transfer, 28% were born at the destination hospital, 49% were transferred early, and 23% were transferred late. Late transfer was more likely for infants of low birthweight (RR 1.74) and infants born to US-born Hispanic (RR 1.69) and black (RR 2.45) mothers. Low birthweight (HR 1.50), low 5-min Apgar score (HR 4.69), and the presence of other major congenital anomalies (HR 3.41), but not timing of transfer, predicted neonatal mortality. Late transfer was more likely in neonates born to US-born Hispanic and black mothers but was not associated with higher mortality.
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Metadaten
Titel
Timing of Transfer and Mortality in Neonates with Hypoplastic Left Heart Syndrome in California
verfasst von
Neha J. Purkey
Chen Ma
Henry C. Lee
Susan R. Hintz
Gary M. Shaw
Doff B. McElhinney
Suzan L. Carmichael
Publikationsdatum
03.02.2021
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 4/2021
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-021-02561-w

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