Faculty Collaboration Database

Transposition of the great arteries--outcomes and time interval of early neonatal repair. World J Pediatr Congenit Heart Surg 2014 Apr;5(2):241-7

Date

03/29/2014

Pubmed ID

24668972

DOI

10.1177/2150135113520559

Scopus ID

2-s2.0-84905175622 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

BACKGROUND: This study evaluates the relationship of morbidity and resource utilization with the timing of early neonatal repair of transposition of the great arteries and intact ventricular septum (d-TGA/IVS).

METHODS: All patients with d-TGA/IVS who underwent arterial switch in the first 14 days of life, between January 2000 and May 2011, were reviewed. Patients undergoing repair at ≤ 4 days of age were categorized as group I, 5 to 7 days as group II, and 8 to 14 days as group III. Outcomes included mortality, morbidity, and resource utilization.

RESULTS: Hospital survival was 69 (98.6%) of 70. The length of stay (LOS) and total charges were lowest in group I--15.5 days compared to group II--18.0 days and group III--23.5 days (P = .005); group I--US$128,219 compared to group II--US$141,729 and group III--US$217,427 (P = .0006). Using regression analysis to account for potentially confounding effects of multiple variables and treating time as a continuous variable demonstrated that age at surgery was significantly associated with total LOS (P = .029), hospital charges (P = .029) and intensive care unit charges (P = .002). Younger age at repair was not associated with worse outcomes for any measure of morbidity.

CONCLUSIONS: Earlier repair of d-TGA/IVS was associated with decreased resource utilization and no detriment to clinical outcomes. Further analysis based on a larger cohort of patients is needed to verify these results that have important implications for improving the value of care.

Author List

Cain MT, Cao Y, Ghanayem NS, Simpson PM, Trapp K, Mitchell ME, Tweddell JS, Woods RK

Authors

Michael Edward Mitchell MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
Ronald K. Woods MD Professor in the Surgery department at Medical College of Wisconsin

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

Cardiac Surgical Procedures
Cost of Illness
Female
Hospital Charges
Hospital Mortality
Humans
Infant, Newborn
Length of Stay
Male
Retrospective Studies
Risk Factors
Transposition of Great Vessels
Treatment Outcome