BACKGROUND: We have shown previously that technical performance score (TPS) is strongly associated with early mortality and major postoperative adverse events in a diverse group of patients. We now report evaluation of the validity of TPS in predicting late outcomes in the same group of patients. METHODS: Patients who underwent surgery between June 1, 2005 and June 30, 2006 were included. The TPS were assigned based on discharge echocardiograms and certain clinical criteria as previously described. Follow-up data for up to 4 years were retrospectively collected. Cox proportional hazards models were used for analysis. RESULTS: A total of 679 patients were included in the analysis. One hundred twenty-three (18%) were neonates, 213 (31%) infants, 291 (435) children, and 52 (8%) adults. Four hundred ninety-one (72%) were in low-risk adjustment in congenital heart surgery (RACHS; 1 to 3), 109 (16%) in high risk (4 to 6), and 27 (4%) were less than 18 years and could not be assigned a RACHS score. Three hundred thirty-one (48%) had an optimal TPS, 283 (42%) adequate, 61 (9%) inadequate, and 4 (1%) could not be scored. There were 34 (5%) late deaths and 149 (22%) late unplanned reinterventions. By univariate analysis, age, RACHS-1 categories, and TPS were all significantly associated with late reintervention (p < 0.001 for all), while TPS and RACHS-1 were significant factors for mortality (p < 0.001). On multivariable modeling, inadequate TPS was strongly associated with both late mortality (p = 0.001; HR [hazard ratio] 3.8, CI [confidence interval] 1.7 to 8.4) and late reintervention (p = 0.002, HR 2.1, CI 1.3 to 3.3) after controlling for RACHS-1 and age. CONCLUSIONS: The TPS has a strong association with late outcomes across a wide range of age and disease complexity and may serve as a tool to identify patients who are at a higher risk for late reintervention or mortality.
BACKGROUND: We have shown previously that technical performance score (TPS) is strongly associated with early mortality and major postoperative adverse events in a diverse group of patients. We now report evaluation of the validity of TPS in predicting late outcomes in the same group of patients. METHODS:Patients who underwent surgery between June 1, 2005 and June 30, 2006 were included. The TPS were assigned based on discharge echocardiograms and certain clinical criteria as previously described. Follow-up data for up to 4 years were retrospectively collected. Cox proportional hazards models were used for analysis. RESULTS: A total of 679 patients were included in the analysis. One hundred twenty-three (18%) were neonates, 213 (31%) infants, 291 (435) children, and 52 (8%) adults. Four hundred ninety-one (72%) were in low-risk adjustment in congenital heart surgery (RACHS; 1 to 3), 109 (16%) in high risk (4 to 6), and 27 (4%) were less than 18 years and could not be assigned a RACHS score. Three hundred thirty-one (48%) had an optimal TPS, 283 (42%) adequate, 61 (9%) inadequate, and 4 (1%) could not be scored. There were 34 (5%) late deaths and 149 (22%) late unplanned reinterventions. By univariate analysis, age, RACHS-1 categories, and TPS were all significantly associated with late reintervention (p < 0.001 for all), while TPS and RACHS-1 were significant factors for mortality (p < 0.001). On multivariable modeling, inadequate TPS was strongly associated with both late mortality (p = 0.001; HR [hazard ratio] 3.8, CI [confidence interval] 1.7 to 8.4) and late reintervention (p = 0.002, HR 2.1, CI 1.3 to 3.3) after controlling for RACHS-1 and age. CONCLUSIONS: The TPS has a strong association with late outcomes across a wide range of age and disease complexity and may serve as a tool to identify patients who are at a higher risk for late reintervention or mortality.
Authors: Anitha Parthiban; Jami C Levine; Meena Nathan; Jennifer A Marshall; Girish S Shirali; Stephen D Simon; Steve D Colan; Jane W Newburger; Geetha Raghuveer Journal: Pediatr Cardiol Date: 2015-09-10 Impact factor: 1.655
Authors: Meena Nathan; Felicia L Trachtenberg; Maria I Van Rompay; William Gaynor; Kirk Kanter; Richard Ohye; Emile A Bacha; James Tweddell; Steven M Schwartz; L LuAnn Minich; Carlos M Mery; Steven D Colan; Jami Levine; Linda M Lambert; Jane W Newburger Journal: J Thorac Cardiovasc Surg Date: 2019-11-15 Impact factor: 5.209
Authors: Meena Nathan; Jami C Levine; Maria I Van Rompay; Linda M Lambert; Felicia L Trachtenberg; Steven D Colan; Iki Adachi; Brett R Anderson; Emile A Bacha; Aaron Eckhauser; J William Gaynor; Eric M Graham; Benjamin Goot; Jeffrey P Jacobs; Rija John; Jonathan R Kaltman; Kirk R Kanter; Carlos M Mery; L LuAnn Minich; Richard Ohye; David Overman; Christian Pizarro; Geetha Raghuveer; Marcus S Schamberger; Steven M Schwartz; Shanthi L Narasimhan; Michael D Taylor; Ke Wang; Jane W Newburger Journal: J Am Coll Cardiol Date: 2021-05-18 Impact factor: 24.094
Authors: Hannah R Bellsham-Revell; Antigoni Deri; Silvia Caroli; Andrew Durward; Owen I Miller; Sujeev Mathur; Jelena Saundankar; David R Anderson; B Conal Austin; Caner Salih; Kuberan Pushparajah; John M Simpson Journal: Echo Res Pract Date: 2019-07-09