Hospital Outcomes Among Infants With Interrupted Aortic Arch With Simple and Complex Associated Heart Defects.

Autor: Sanchez Mejia AA; Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine Houston, Texas. Electronic address: sanchezmejia@bcm.edu., Cambronero N; Department of Cardiovascular Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas., Dongarwar D; Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine Houston, Texas., Salihu HM; Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine Houston, Texas., Vigil-Mallette MA; Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine Houston, Texas., Garcia BY; Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine Houston, Texas., Morris SA; Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2022 Mar 01; Vol. 166, pp. 97-106. Date of Electronic Publication: 2021 Dec 29.
DOI: 10.1016/j.amjcard.2021.11.032
Abstrakt: There is a lack of current, multi-institutional data regarding hospital outcomes of infants with interrupted aortic arch (IAA). We analyzed the Pediatric Health Information System database to identify infants with IAA who underwent repair during 2004 to 2019. We classified patients as simple or complex based on associated heart defects. We evaluated factors associated with hospital mortality and complications related to 22q11.2 deletion syndrome (22q11.2del) using mixed logistic regression, accounting for hospital clustering. In 1,283 infants included (904 simple, 379 complex), mortality was higher in the complex group (11.7% vs 4.4%, p <0.001). Factors associated with mortality in the simple group were low birth weight (adjusted risk ratio [aRR] 3.77, 95% confidence interval [95% CI] 1.83 to 7.77), non-22q11.2del genetic conditions (aRR 6.44, 95% CI 1.73 to 23.96), and gastrointestinal anomalies (aRR 8.47, 95% CI 3.12 to 22.95), whereas surgery between 2012 and 2015 (aRR 0.36, 95% CI 0.13 to 0.99) was protective. In the complex group, factors associated with mortality were male (aRR 2.32, 95% CI 1.10 to 4.24) and central nervous system anomalies (aRR 3.73, 95% CI 1.62 to 8.59). Compared with their nonsyndromic counterparts, infants with simple IAA and 22q11.2del were at higher risk of sepsis (aRR 1.63, 95% CI 1.02 to 2.39) and gastrostomy tube placement (aRR 3.18, 95% CI 2.13 to 4.74), and infants with complex IAA and 22q11.2del were at higher risk of gastrostomy tube placement (aRR 2.42, 95% CI 1.20 to 4.88). In conclusion, presence of complex cardiac lesions is associated with increased mortality after IAA repair. The co-occurrence of extracardiac congenital anomalies and non-22q11.2del genetic conditions elevates mortality risk. Presence of 22q11.2del is associated with hospital complications.
Competing Interests: Disclosures The authors have no conflicts of interest to declare.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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