Document Detail


Congenital heart surgery outcomes in Down syndrome: analysis of a national clinical database.
MedLine Citation:
PMID:  20624800     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We describe patient characteristics and postoperative morbidity and mortality rates for patients with Down syndrome undergoing congenital heart disease surgery. METHODS: This retrospective cohort study used the Society of Thoracic Surgeons Congenital Heart Surgery Database to compare patient characteristics and postoperative outcomes for patients (0-18 years) with or without Down syndrome who underwent surgery in 2000-2008. RESULTS: A total of 45,579 patients (4350 patients with Down syndrome and 41,229 without Down syndrome) were included (median age: 7 months [interquartile range [IQR]: 47 days to 4 years]; 56% male). Patients with Down syndrome were younger at surgery, with the exception of those undergoing tetralogy of Fallot repair or atrioventricular septal defect repair. Mortality rates for patients with or without Down syndrome did not differ significantly. Lengths of stay were prolonged for patients with Down syndrome undergoing atrial septal defect closure (median: 4 days [IQR: 3-5 days] vs 3 days [IQR: 2-4 days]; P < .0001), ventricular septal defect closure (median: 5 days [IQR: 4-8 days] vs 4 days [IQR: 3-6 days]; P < .0001), or tetralogy of Fallot repair (7 days [IQR: 5-10 days] vs 6 days [IQR: 5-9 days]; P < .001) and were associated with postoperative respiratory and infectious complications. Patients with Down syndrome undergoing ventricular septal defect closure had a higher rate of heart block requiring pacemaker placement (2.9% vs 0.8%; P < .0001). CONCLUSION: In this large, contemporary cohort, Down syndrome did not confer a significant mortality risk for the most common operations; however, postoperative morbidity remained common.
Authors:
James C Fudge; Shuang Li; James Jaggers; Sean M O'Brien; Eric D Peterson; Jeffrey P Jacobs; Karl F Welke; Marshall L Jacobs; Jennifer S Li; Sara K Pasquali
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-07-12
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2010-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  315-22     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC 27715, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cardiac Surgical Procedures / methods*
Child
Child, Preschool
Databases, Factual
Down Syndrome / epidemiology*
Female
Heart Defects, Congenital / epidemiology*,  mortality,  surgery*
Heart Septal Defects / mortality,  surgery
Humans
Infant
Infant, Newborn
Male
Postoperative Complications / mortality*
Prevalence
Retrospective Studies
Survival Rate
United States / epidemiology
Grant Support
ID/Acronym/Agency:
KL2 RR024127-02/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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