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Published in: BMC Cardiovascular Disorders 1/2019

Open Access 01-12-2019 | Tetralogy of Fallot | Research article

Impact of timing on in-patient outcomes of complete repair of tetralogy of Fallot in infancy: an analysis of the United States National Inpatient 2005–2011 database

Authors: Shihai Yang, Linlin Wen, Shuguang Tao, Jiangrong Gu, Jiangang Han, Junping Yao, Jianming Wang

Published in: BMC Cardiovascular Disorders | Issue 1/2019

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Abstract

Background

This study aimed to investigate whether age at complete repair of tetralogy of Fallot (TOF) impacts postoperative morbidity and length of hospital stay in infants less than 365 days of age.

Methods

The United States Nationwide Inpatient Sample was searched for infants 0–365 days of age that underwent complete repair of TOF between 2005 and 2011. Patients were categorized based on age at time of repair: 0–30 days; 31–90 days; 91–180 days; > 180 days.

Results

A total of 1112 infants were included in the study. Multivariate analysis showed the risk of postoperative complications was 40% lower in infants ≥91 days old at the time of repair as compared to those ≤30 days old. In addition, children > 30 days old at the time of repair had a significantly shorter length of hospital stay than those aged ≤30 days. In the subgroup with elective repair, older age was associated with a shorter length of hospital stay as compared to those ≤30 days old at repair, while association between age at complete repair of TOF and postoperative complication was not significant among the groups after adjusting for confounders.

Conclusions

In children < 1 year old, postoperative complications and length of hospital stay are affected by the timing of complete repair of TOF.
Literature
1.
go back to reference Talner CN. Report of the New England regional infant cardiac program. Pediatrics. 1980;65(Suppl):375–461. Talner CN. Report of the New England regional infant cardiac program. Pediatrics. 1980;65(Suppl):375–461.
2.
go back to reference Centers for Disease Control and Prevention (CDC). Improved national prevalence estimates for 18 selected major birth defects – United States 1999–2001. MMWR. 2006;54:1301–5. Centers for Disease Control and Prevention (CDC). Improved national prevalence estimates for 18 selected major birth defects – United States 1999–2001. MMWR. 2006;54:1301–5.
3.
go back to reference Al Habib HF, Jacobs JP, Mavroudis C, Tchervenkov CI, O'Brien SM, Mohammadi S, et al. Contemporary patterns of management of tetralogy of Fallot: data from the Society of Thoracic Surgeons database. Ann Thorac Surg. 2010;90:813–9.CrossRef Al Habib HF, Jacobs JP, Mavroudis C, Tchervenkov CI, O'Brien SM, Mohammadi S, et al. Contemporary patterns of management of tetralogy of Fallot: data from the Society of Thoracic Surgeons database. Ann Thorac Surg. 2010;90:813–9.CrossRef
4.
go back to reference Barron DJ. Tetralogy of Fallot: controversies in early management. World J Pediatr Congenit Heart Surg. 2013;4:186–91.CrossRef Barron DJ. Tetralogy of Fallot: controversies in early management. World J Pediatr Congenit Heart Surg. 2013;4:186–91.CrossRef
5.
go back to reference Downing TE, Kim YY. Tetralogy of Fallot: general principles of management. Cardiol Clin. 2015;33:531–41.CrossRef Downing TE, Kim YY. Tetralogy of Fallot: general principles of management. Cardiol Clin. 2015;33:531–41.CrossRef
6.
go back to reference Lindberg HL, Saatvedt K, Seem E, Hoel T, Birkeland S. Single-center 50 years' experience with surgical management of tetralogy of Fallot. Eur J Cardiothorac Surg. 2011;40:538–42.PubMed Lindberg HL, Saatvedt K, Seem E, Hoel T, Birkeland S. Single-center 50 years' experience with surgical management of tetralogy of Fallot. Eur J Cardiothorac Surg. 2011;40:538–42.PubMed
7.
go back to reference Mulder TJ, Pyles LA, Stolfi A, Pickoff AS, Moller JH. A multicenter analysis of the choice of initial surgical procedure in tetralogy of Fallot. Pediatr Cardiol. 2002;23:580–6.CrossRef Mulder TJ, Pyles LA, Stolfi A, Pickoff AS, Moller JH. A multicenter analysis of the choice of initial surgical procedure in tetralogy of Fallot. Pediatr Cardiol. 2002;23:580–6.CrossRef
8.
go back to reference Kanter KR, Kogon BE, Kirshbom PM, Carlock PR. Symptomatic neonatal tetralogy of Fallot: repair or shunt? Ann Thorac Surg. 2010;89:858–63.CrossRef Kanter KR, Kogon BE, Kirshbom PM, Carlock PR. Symptomatic neonatal tetralogy of Fallot: repair or shunt? Ann Thorac Surg. 2010;89:858–63.CrossRef
9.
go back to reference Pigula FA, Khalil PN, Mayer JE, del Nido PJ, Jonas RA. Repair of tetralogy of Fallot in neonates and young infants. Circulation. 1999;100(Suppl):II157–61.PubMed Pigula FA, Khalil PN, Mayer JE, del Nido PJ, Jonas RA. Repair of tetralogy of Fallot in neonates and young infants. Circulation. 1999;100(Suppl):II157–61.PubMed
10.
go back to reference Parry AJ, McElhinney DB, Kung GC, Reddy VM, Brook MM, Hanley FL. Elective primary repair of acyanotic tetralogy of Fallot in early infancy: overall outcome and impact on the pulmonary valve. J Am Coll Cardiol. 2000;36:2279–83.CrossRef Parry AJ, McElhinney DB, Kung GC, Reddy VM, Brook MM, Hanley FL. Elective primary repair of acyanotic tetralogy of Fallot in early infancy: overall outcome and impact on the pulmonary valve. J Am Coll Cardiol. 2000;36:2279–83.CrossRef
11.
go back to reference Reddy VM, Liddicoat JR, McElhinney DB, Brook MM, Stanger P, Hanley FL. Routine primary repair of tetralogy of Fallot in neonates and infants less than three months of age. Ann Thorac Surg. 1995;60:S592–6.CrossRef Reddy VM, Liddicoat JR, McElhinney DB, Brook MM, Stanger P, Hanley FL. Routine primary repair of tetralogy of Fallot in neonates and infants less than three months of age. Ann Thorac Surg. 1995;60:S592–6.CrossRef
12.
go back to reference Van Arsdell GS, Maharaj GS, Tom J, Rao VK, Coles JG, Freedom RM, et al. What is the optimal age for repair of tetralogy of Fallot? Circulation. 2000;102(Suppl 3):III123–9.PubMed Van Arsdell GS, Maharaj GS, Tom J, Rao VK, Coles JG, Freedom RM, et al. What is the optimal age for repair of tetralogy of Fallot? Circulation. 2000;102(Suppl 3):III123–9.PubMed
13.
go back to reference Kirsch RE, Glatz AC, Gaynor JW, Nicolson SC, Spray TL, Wernovsky G, et al. Results of elective repair at 6 months or younger in 277 patients with tetralogy of Fallot: a 14-year experience at a single center. J Thorac Cardiovasc Surg. 2014;147:713–7.CrossRef Kirsch RE, Glatz AC, Gaynor JW, Nicolson SC, Spray TL, Wernovsky G, et al. Results of elective repair at 6 months or younger in 277 patients with tetralogy of Fallot: a 14-year experience at a single center. J Thorac Cardiovasc Surg. 2014;147:713–7.CrossRef
14.
go back to reference Ooi A, Moorjani N, Baliulis G, Keeton BR, Salmon AP, Monro JL, et al. Medium term outcome for infant repair in tetralogy of Fallot: indicators for timing of surgery. Eur J Cardiothorac Surg. 2006;30:917–22.CrossRef Ooi A, Moorjani N, Baliulis G, Keeton BR, Salmon AP, Monro JL, et al. Medium term outcome for infant repair in tetralogy of Fallot: indicators for timing of surgery. Eur J Cardiothorac Surg. 2006;30:917–22.CrossRef
15.
go back to reference Vohra HA, Adamson L, Haw MP. Is early primary repair for correction of tetralogy of Fallot comparable to surgery after 6 months of age? Interact Cardiovasc Thorac Surg. 2008;7:698–701.CrossRef Vohra HA, Adamson L, Haw MP. Is early primary repair for correction of tetralogy of Fallot comparable to surgery after 6 months of age? Interact Cardiovasc Thorac Surg. 2008;7:698–701.CrossRef
16.
go back to reference Kantorova A, Zbieranek K, Sauer H, Lilje C, Haun C, Hraska V. Primary early correction of tetralogy of Fallot irrespective of age. Cardiol Young. 2008;18:153–7.CrossRef Kantorova A, Zbieranek K, Sauer H, Lilje C, Haun C, Hraska V. Primary early correction of tetralogy of Fallot irrespective of age. Cardiol Young. 2008;18:153–7.CrossRef
17.
go back to reference Woldu KL, Arya B, Bacha EA, Williams IA. Impact of neonatal versus non-neonatal total repair of tetralogy of Fallot on growth in the first year of life. Ann Thorac Surg. 2014;98:1399–404.CrossRef Woldu KL, Arya B, Bacha EA, Williams IA. Impact of neonatal versus non-neonatal total repair of tetralogy of Fallot on growth in the first year of life. Ann Thorac Surg. 2014;98:1399–404.CrossRef
18.
go back to reference Loomba RS, Buelow MW, Woods RK. Complete repair of tetralogy of Fallot in the neonatal versus non-neonatal period: a meta-analysis. Pediatr Cardiol. 2017;38(5):893–901.CrossRef Loomba RS, Buelow MW, Woods RK. Complete repair of tetralogy of Fallot in the neonatal versus non-neonatal period: a meta-analysis. Pediatr Cardiol. 2017;38(5):893–901.CrossRef
19.
go back to reference Steiner MB, Tang X, Gossett JM, Malik S, Prodhan P. Timing of complete repair of non-ductal-dependent tetralogy of Fallot and short-term postoperative outcomes, a multicenter analysis. J Thorac Cardiovasc Surg. 2014;147:1299–305.CrossRef Steiner MB, Tang X, Gossett JM, Malik S, Prodhan P. Timing of complete repair of non-ductal-dependent tetralogy of Fallot and short-term postoperative outcomes, a multicenter analysis. J Thorac Cardiovasc Surg. 2014;147:1299–305.CrossRef
20.
go back to reference Introduction to the Nationwide Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality, Rockville. 2008. https://www.hcup-us.ahrq.gov/. Introduction to the Nationwide Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality, Rockville. 2008. https://​www.​hcup-us.​ahrq.​gov/.
21.
go back to reference Mimic B, Brown KL, Oswal N, et al. Neither age at repair nor previous palliation affects outcome in tetralogy of Fallot repair. Eur J Cardiothorac Surg. 2014;45:92–8.CrossRef Mimic B, Brown KL, Oswal N, et al. Neither age at repair nor previous palliation affects outcome in tetralogy of Fallot repair. Eur J Cardiothorac Surg. 2014;45:92–8.CrossRef
Metadata
Title
Impact of timing on in-patient outcomes of complete repair of tetralogy of Fallot in infancy: an analysis of the United States National Inpatient 2005–2011 database
Authors
Shihai Yang
Linlin Wen
Shuguang Tao
Jiangrong Gu
Jiangang Han
Junping Yao
Jianming Wang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2019
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-019-0999-1

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