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 |
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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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