Jenifer Tregay1, Jo Wray1, Catherine Bull1, Rodney C Franklin2, Piers Daubeney2, David J Barron3, Katherine Brown1, Rachel L Knowles4. 1. 1Cardiorespiratory Unit,Great Ormond Street Hospital NHS Foundation Trust,London,United Kingdom. 2. 2Department of Paediatric Cardiology,Royal Brompton & Harefield NHS Trust,London,United Kingdom. 3. 3Cardiac Unit,Birmingham Children's Hospital NHS Foundation Trust,Birmingham,United Kingdom. 4. 4Population Policy and Practice Programme,UCL Institute of Child Health,London,United Kingdom.
Abstract
BACKGROUND: Babies with CHDs are a particularly vulnerable population with significant mortality in their 1st year. Although most deaths occur in the hospital within the early postoperative period, around one-fifth of postoperative deaths in the 1st year of life may occur after hospital discharge in infants who have undergone apparently successful cardiac surgery. Aim To systematically review the published literature and identify risk factors for adverse outcomes, specifically deaths and unplanned re-admissions, following hospital discharge after infant surgery for life-threatening CHDs. METHODS: A systematic search was conducted in MEDLINE, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and PsycINFO electronic databases, supplemented by manual searching of conference abstracts. RESULTS: A total of 15 studies were eligible for inclusion. Almost exclusively, studies were conducted in single US centres and focussed on children with complex single ventricle diagnoses. A wide range of risk factors were evaluated, and those more frequently identified as having a significant association with higher mortality or unplanned re-admission risk were non-Caucasian ethnicity, lower socio-economic status, co-morbid conditions, age at surgery, operative complexity and procedure type, and post-operative feeding difficulties. CONCLUSIONS: Studies investigating risk factors for adverse outcomes post-discharge following diverse congenital heart operations in infants are lacking. Further research is needed to systematically identify higher risk groups, and to develop interventions targeted at supporting the most vulnerable infants within an integrated primary and secondary care pathway.
BACKGROUND: Babies with CHDs are a particularly vulnerable population with significant mortality in their 1st year. Although most deaths occur in the hospital within the early postoperative period, around one-fifth of postoperative deaths in the 1st year of life may occur after hospital discharge in infants who have undergone apparently successful cardiac surgery. Aim To systematically review the published literature and identify risk factors for adverse outcomes, specifically deaths and unplanned re-admissions, following hospital discharge after infant surgery for life-threatening CHDs. METHODS: A systematic search was conducted in MEDLINE, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and PsycINFO electronic databases, supplemented by manual searching of conference abstracts. RESULTS: A total of 15 studies were eligible for inclusion. Almost exclusively, studies were conducted in single US centres and focussed on children with complex single ventricle diagnoses. A wide range of risk factors were evaluated, and those more frequently identified as having a significant association with higher mortality or unplanned re-admission risk were non-Caucasian ethnicity, lower socio-economic status, co-morbid conditions, age at surgery, operative complexity and procedure type, and post-operative feeding difficulties. CONCLUSIONS: Studies investigating risk factors for adverse outcomes post-discharge following diverse congenital heart operations in infants are lacking. Further research is needed to systematically identify higher risk groups, and to develop interventions targeted at supporting the most vulnerable infants within an integrated primary and secondary care pathway.
Authors: Devin M Parker; Allen D Everett; Meagan E Stabler; Luca Vricella; Marshall L Jacobs; Jeffrey P Jacobs; Chirag R Parikh; Sara K Pasquali; Jeremiah R Brown Journal: Ann Thorac Surg Date: 2019-07-16 Impact factor: 4.330
Authors: Jeremiah R Brown; Meagan E Stabler; Devin M Parker; Luca Vricella; Sara Pasquali; JoAnna K Leyenaar; Andrew R Bohm; Todd MacKenzie; Chirag Parikh; Marshall L Jacobs; Jeffrey P Jacobs; Allen D Everett Journal: Cardiol Young Date: 2019-07-10 Impact factor: 1.093
Authors: Devin M Parker; Allen D Everett; Meagan E Stabler; Marshall L Jacobs; Jeffrey P Jacobs; Luca Vricella; Heather Thiessen-Philbrook; Chirag R Parikh; Cedric Manlhiot; Jeremiah R Brown Journal: Ann Thorac Surg Date: 2020-04-01 Impact factor: 4.330
Authors: Sonya Crowe; Deborah A Ridout; Rachel Knowles; Jenifer Tregay; Jo Wray; David J Barron; David Cunningham; Roger C Parslow; Martin Utley; Rodney Franklin; Catherine Bull; Katherine L Brown Journal: J Am Heart Assoc Date: 2016-05-20 Impact factor: 5.501
Authors: Sonya Crowe; Rachel Knowles; Jo Wray; Jenifer Tregay; Deborah A Ridout; Martin Utley; Rodney Franklin; Catherine L Bull; Katherine L Brown Journal: BMJ Open Date: 2016-06-06 Impact factor: 2.692
Authors: Jo Wray; Katherine Brown; Jenifer Tregay; Sonya Crowe; Rachel Knowles; Kate Bull; Faith Gibson Journal: J Med Internet Res Date: 2018-05-09 Impact factor: 5.428