Yuki Koichi, Koutsogiannaki Sophia, Lee Sandra, DiNardo James A
Department of Anaesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.
Department of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA, USA.
Paediatr Anaesth. 2018 Jul;28(7):607-611. doi: 10.1111/pan.13388. Epub 2018 May 18.
An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken.
The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission.
This is a retrospective study of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis in a single center. Using the electronic preoperative anesthesia evaluation form, we identified 3010 patients with congenital heart disease who underwent noncardiac procedures of which 1028 (34.1%) were scheduled to occur on an ambulatory basis. Demographic, echocardiographic and functional status data, cardiovascular and respiratory adverse events, and reasons for postprocedure admission were recorded. Univariable analysis was conducted.
The unplanned hospital admission was 2.7% and univariable analysis demonstrated that performance of an echocardiogram within 6 mo of the procedure and procedures performed in radiology were associated with postoperative admission. Cardiovascular adverse event incidence was 3.9%. Respiratory adverse event incidence was 1.8%.
Ambulatory, noncomplex procedures can be performed in pediatric patients with congenital heart disease and good functional status with a relatively low unanticipated hospital admission rate.
越来越多的外科和非外科手术在儿童门诊进行。尚未对一大组接受门诊手术的先天性心脏病儿科患者进行分析。
本研究的目的是描述在我们机构接受门诊非心脏手术的先天性心脏病患儿的特征，确定心血管和呼吸不良事件的发生率，并确定非计划住院的危险因素。
这是一项对在单一中心接受门诊非心脏手术的先天性心脏病患儿的回顾性研究。使用电子术前麻醉评估表，我们确定了3010例接受非心脏手术的先天性心脏病患者，其中1028例（34.1%）计划在门诊进行。记录人口统计学、超声心动图和功能状态数据、心血管和呼吸不良事件以及术后入院原因。进行单变量分析。
非计划住院率为2.7%，单变量分析表明，在手术6个月内进行超声心动图检查以及在放射科进行的手术与术后住院有关。心血管不良事件发生率为3.9%。呼吸不良事件发生率为1.8%。
对于功能状态良好的先天性心脏病儿科患者，可以进行门诊非复杂手术，意外住院率相对较低。
