Faculty Collaboration Database

Morbidity and Mortality After Gastrostomy Tube Placement Among Infants With Congenital Heart Disease. J Surg Res 2025 Sep;313:26-33

Date

07/12/2025

Pubmed ID

40645068

DOI

10.1016/j.jss.2025.06.009

Scopus ID

2-s2.0-105010210773 (requires institutional sign-in at Scopus site)

Abstract

INTRODUCTION: We sought to characterize the morbidity and mortality associated with gastrostomy tube (GT) placement in infants with cardiac risk factors.

METHODS: A cross-sectional study using the National Surgical Quality Improvement Program-Pediatric from 2012 to 2021 was completed. Infants (aged ≤365 d) undergoing a GT placement were stratified by preoperative cardiac risk factors and analyzed for the composite occurrence of death, stroke, and/or cardiac arrest.

RESULTS: There were 20,823 infants analyzed. The composite outcome occurred in 56 (0.7%) patients with no cardiac risk factors, 62 (1.2%) patients with minor risk factors, 130 (2.0%) patients with major risk factors, and 55 (4.2%) patients with severe risk factors (P < 0. 001). The composite outcome was significantly associated with age <3 mo (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.05-2.05), ventilator dependence (OR 2.23, 95% CI 1.52-3.28), and oxygen support (OR 2.22, 95% CI 1.59-3.11). Of the 1084 patients with diagnoses consistent with single ventricle physiology, there were 26 deaths (2.7%); 21 (81%) were aged <3 mo at the time of GT placement.

CONCLUSIONS: Infants with cardiac disease undergoing GT placement have significant morbidity and mortality. Factors including age <3 mo, ventilator dependence, and oxygen support were strongly associated with an increased risk of death, stroke, or cardiac arrest. The high risk of the procedure should be considered when evaluating the feeding plan for infants with congenital heart disease.

Author List

Salazar JH, Schuh JM, Bence CM, Van Arendonk KJ, Tanem JM, Arca MJ

Authors

Jose Salazar Osuna MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Justinn M. Tanem MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cross-Sectional Studies
Enteral Nutrition
Female
Gastrostomy
Heart Arrest
Heart Defects, Congenital
Humans
Infant
Infant, Newborn
Male
Postoperative Complications
Retrospective Studies
Risk Factors
Stroke