| Congenital heart surgery outcomes in Down syndrome: analysis of a national clinical database. | |
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MedLine Citation:
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PMID: 20624800 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-07-12 |
Journal Detail:
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Title: Pediatrics Volume: 126 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-03 Completed Date: 2010-09-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 315-22 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC 27715, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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KL2 RR024127-02/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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