Document Detail


Risk factors for deaths occurring within 30 days and 1 year after hospital discharge for cardiac surgery among pediatric patients.
MedLine Citation:
PMID:  16875927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known regarding the risk factors for early and late death after hospital discharge among pediatric patients undergoing cardiac surgery. METHODS: Statewide hospital discharge data from California in 1989 to 1999 were used to study outcomes of children <18 years old who had a procedure code (by International Classification of Diseases, Ninth Revision, Clinical Modification) indicating cardiac surgery. The outcome variable was death occurring after hospital discharge. Postdischarge deaths were identified by linking hospital discharge data to statewide death registry data. Cardiac surgical procedures were grouped into 23 categories to adjust for risk involved with the procedures. We used logistic regression to evaluate risk factors for postdischarge mortality, including variables age, sex, race and ethnicity, type of insurance, home income, date and month of surgery, type of admission, hospitals case volume, and the various types of procedures. RESULTS: There were 25,402 cardiac surgery cases with 1505 inhospital deaths. Of 23,897 hospital discharges, 148 deaths (0.62%) occurred within 365 days after discharge, including 37 deaths within 30 days; 44 deaths at 31 to 90 days; and 67 deaths at 91 to 365 days. Logistic regression showed young age was an important risk factor for postdischarge death with an odds ratio of 4.8 for neonates and 3.5 for infants, compared with children >1 year old. Another significant risk factor was the type of procedure. For death <30 days after discharge, Norwood operation (odds ratio 8.4 compared with closure of ventricular septal defect) was a risk factor. For death that occurred between 31 and 365 days, significant risk factors were truncus arteriosus repair, total anomalous pulmonary vein repair, aortopulmonary shunt, and open valvotomy. Sex, race/ethnicity, home income, and hospital case volume were not significant predictors of postdischarge deaths. CONCLUSIONS: Many demographic and socioeconomic variables affecting inhospital death were not significant predictors for postdischarge death. Important risk factors for postdischarge death were young age and the type of surgery performed.
Authors:
Ruey-Kang R Chang; Sandra Rodriguez; Maggie Lee; Thomas S Klitzner
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  152     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-31     Completed Date:  2006-09-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-93     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. rkchang@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Algorithms
California / epidemiology
Cardiac Surgical Procedures / mortality*
Child
Child, Preschool
Female
Glyceraldehyde-3-Phosphate Dehydrogenases
Heart Septal Defects / mortality,  surgery
Humans
Infant
Infant, Newborn
Insurance, Health
Logistic Models
Male
Odds Ratio
Peptide Fragments
Risk Factors
Sex Factors
Time Factors
Grant Support
ID/Acronym/Agency:
1 K23 RR17041-01/RR/NCRR NIH HHS; 1 R03 HS13217-01/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Peptide Fragments; 130349-12-1/glyceraldehyde 3-phosphate dehydrogenase (304-313); EC 1.2.1.-/Glyceraldehyde-3-Phosphate Dehydrogenases

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


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