Department of Pediatrics (Cardiology and Pediatric Intensive Care), University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 1 Children's Way, Slot 512-1, Little Rock, AR, 72202, USA.
Arkansas Children's Research Institute (Biostatistics), Little Rock, USA.
Pediatr Cardiol. 2021 Oct;42(7):1567-1574. doi: 10.1007/s00246-021-02641-x. Epub 2021 May 29.
Coarctation of the aorta is a relatively common congenital heart disease occurring in 0.4-0.6 per 1000 live births with a low mortality rate. This is a retrospective study, with data abstracted from the Pediatric Health Information System database (PHIS). The study sample included pediatric patients less than or equal to 3 months of age discharged from a PHIS participating hospital between January 1, 2004 and December 31, 2018 who underwent surgical repair of isolated COA. The primary outcome for the study was post-operative hospital length of stay (PH-LOS), and the secondary outcome was in-hospital mortality. Patient demographics, comorbidities, procedures, and outcomes were assessed for statistical differences between eras. A total of 5354 patients were included in the study. The study highlights an increasing trend in PH-LOS and NICU hospital length of stay (NICU-LOS) across the investigated eras. Prematurity (before 37 weeks gestation) was an independent risk factor associated with both longer post-operative length of the stay and higher mortality. In addition, congenital anomalies, respiratory and abdominal surgeries have a significant impact on the post-operative hospital stay. In conclusion, this study is the largest published systematic assessment of PH-LOS in patients with isolated COA repair during infancy to date and identifies independent risk factors of increased PH-LOS.
主动脉缩窄是一种相对常见的先天性心脏病，每 1000 例活产中发病率为 0.4-0.6 例，死亡率较低。这是一项回顾性研究，数据来自儿科健康信息系统（PHIS）数据库。研究样本包括 2004 年 1 月 1 日至 2018 年 12 月 31 日期间在 PHIS 参与医院出院的年龄小于或等于 3 个月的儿科患者，这些患者接受了孤立性 COA 的手术修复。该研究的主要结果是术后住院时间（PH-LOS），次要结果是院内死亡率。评估了患者的人口统计学特征、合并症、手术程序和结果，以比较各时期之间的统计学差异。本研究共纳入 5354 例患者。研究结果表明，在研究期间，PH-LOS 和新生儿重症监护病房（NICU）住院时间（NICU-LOS）呈持续增加趋势。早产（妊娠 37 周前）是与术后住院时间延长和死亡率升高相关的独立危险因素。此外，先天性畸形、呼吸系统和腹部手术对术后住院时间有显著影响。总之，这是迄今为止发表的关于婴幼儿孤立性 COA 修复患者 PH-LOS 的最大系统评估研究，确定了 PH-LOS 延长的独立危险因素。
