Department of Child Health, Dr. Sardjito Hospital / Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Kesehatan No 1, Sekip, Yogyakarta, 55281, Indonesia.
BMC Pediatr. 2021 Apr 21;21(1):191. doi: 10.1186/s12887-021-02667-3.
Delayed diagnosis of congenital heart disease (CHD) causes significant morbidity and mortality. We aimed to determine the proportion of delayed diagnosis of CHD and factors related to the delayed diagnosis.
A prospective cohort study with mixed-methods was conducted in Dr. Sardjito Hospital, Yogyakarta, Indonesia. Patients aged < 18 years with newly diagnosed CHD and echocardiography confirmed CHD were included. Data were recorded from medical records and interviews from direct caregivers. Logistic regression was used to identify independent factors associated with the delay.
A total of 838 patients were included with median age of 2.9 years (0-17.7 years), with female predominance (54.2%, n = 454). The proportions of delayed diagnosis were 60.8% (510), 54.9% (373) and 86.2% (137) in all children with CHD, acyanotic and cyanotic CHD, respectively. Delayed diagnosis by doctor was the most common cause, followed by delayed diagnosis related to midwifery care, financial, referral/follow-up, and social factors. In multivariate analysis, cyanotic CHD, residence outside the city, non-syndromic, low family income, normal labour and at term gestation at birth were independently associated with the delay. At diagnosis, heart failure and pulmonary hypertension occurred in 414 (49.4%) and 132 (15.8%) children with CHD, respectively.
Six in ten children with CHD were diagnosed with significant delay. Delayed diagnosis by doctor was the most common cause. Children with cyanotic CHD, residence outside the city, non-syndromic, low family income, normal labour and at term gestation at birth were independently associated with the delay. Comorbid complications in delayed diagnosis of CHD were prevalent.
先天性心脏病（CHD）的延迟诊断会导致显著的发病率和死亡率。我们旨在确定 CHD 延迟诊断的比例以及与延迟诊断相关的因素。
在印度尼西亚日惹的 Sardjito 医院进行了一项前瞻性队列研究，采用混合方法。纳入年龄<18 岁且新诊断为 CHD 并经超声心动图证实为 CHD 的患者。从病历和直接照顾者的访谈中记录数据。使用逻辑回归来确定与延迟相关的独立因素。
共纳入 838 例患者，中位年龄为 2.9 岁（0-17.7 岁），女性居多（54.2%，n=454）。所有 CHD 患儿、非发绀型 CHD 和发绀型 CHD 的延迟诊断比例分别为 60.8%（510）、54.9%（373）和 86.2%（137）。医生延迟诊断是最常见的原因，其次是与助产护理、财务、转诊/随访和社会因素相关的延迟诊断。多变量分析显示，发绀型 CHD、居住地在城市外、非综合征性、家庭收入低、正常分娩和足月产与延迟相关。在诊断时，心力衰竭和肺动脉高压分别发生在 414（49.4%）和 132（15.8%）例 CHD 患儿中。
十分之六的 CHD 患儿存在明显的延迟诊断。医生延迟诊断是最常见的原因。发绀型 CHD、居住地在城市外、非综合征性、家庭收入低、正常分娩和足月产与延迟相关。CHD 延迟诊断的合并并发症较为普遍。
