Predictors of death after receiving a modified Blalock-Taussig shunt in cyanotic heart children: A competing risk analysis

Autor: Jutarat Tanasansuttiporn, Voravit Chittithavorn, Pongsanae Duangpakdee, Qistina Yunuswangsa, Wirat Wasinwong, Maliwan Oofuvong, Jirayut Jarutach
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Epidemiology
Cardiovascular Medicine
030204 cardiovascular system & hematology
Vascular Medicine
Cohort Studies
Families
Medical Conditions
0302 clinical medicine
Medicine and Health Sciences
Children
Tetralogy of Fallot
Multidisciplinary
Hazard ratio
Heart
Hematology
Prognosis
Chemistry
Cardiovascular Diseases
Child
Preschool
Physical Sciences
Cardiology
Medicine
Female
Anatomy
Pulmonary atresia
Shunt (electrical)
Research Article
Chemical Elements
Cohort study
Heart Defects
Congenital
medicine.medical_specialty
Cardiac Ventricles
Death Rates
Science
Hemorrhage
Surgical and Invasive Medical Procedures
Risk Assessment
03 medical and health sciences
Signs and Symptoms
Population Metrics
Internal medicine
medicine
Humans
Blalock-Taussig Procedure
Blood Coagulation
Retrospective Studies
Toddlers
Coagulation Disorders
Population Biology
business.industry
Infant
Newborn
Infant
Biology and Life Sciences
Thrombosis
Retrospective cohort study
Perioperative
medicine.disease
Confidence interval
Oxygen
030228 respiratory system
Age Groups
Medical Risk Factors
People and Places
Cardiovascular Anatomy
Population Groupings
Clinical Medicine
business
Zdroj: PLoS ONE, Vol 16, Iss 1, p e0245754 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Objective To determine risk factors affecting time-to-death ≤90 and >90 days in children who underwent a modified Blalock-Taussig shunt (MBTS). Methods Data from a retrospective cohort study were obtained from children aged 0–3 years who experienced MBTS between 2005 and 2016. Time-to-death (prior to Glenn/repair), time-to-alive up until December 2017 without repair, and time-to-progression to Glenn/repair following MBTS were presented using competing risks survival analysis. Demographic, surgical and anesthesia-related factors were recorded. Time-to-death ≤90 days and >90 days was analyzed using multivariate time-dependent Cox regression models to identify independent predictors and presented by adjusted hazard ratios (HR) and 95% confidence intervals (CI). Results Of 380 children, 119 died, 122 survived and 139 progressed to Glenn/repair. Time-to-death probability (95% CI) within 90 days was 0.18 (0.14–0.22). Predictors of time-to-death ≤90 days (n = 63) were low weight (90 days (n = 56) were children diagnosed with pulmonary atresia with ventricular septal defect and single ventricle (compared to tetralogy of fallot) (HR 3.2, 95% CI:1.2–7.7 and HR 3.1, 95% CI:1.3–7.6, respectively), shunt size/weight ratio >1.1 vs Conclusions Perioperative factors were associated with time-to-death ≤90 days, whereas particular cardiac defect, larger shunt size/weight ratio, and longer mechanical ventilation were associated with time-to-death >90 days after receiving MBTS. Larger shunt size/weight ratio should be reevaluated within 90 days to minimize the risk of shunt over flow.
Databáze: OpenAIRE
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