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Younger age remains a risk factor for prolonged length of stay after bidirectional cavopulmonary anastomosis.

Authors :
Koth AM
Algaze CA
Sakarovitch C
Long J
Kamra K
Wright GE
Alexander-Banys B
Maeda K
Shin AY
Source :
Cardiology in the young [Cardiol Young] 2019 Mar; Vol. 29 (3), pp. 369-374. Date of Electronic Publication: 2019 Jan 30.
Publication Year :
2019

Abstract

Objective: This study sets out to determine the influence of age at the time of surgery as a risk factor for post-operative length of stay after bidirectional cavopulmonary anastomosis.<br />Methods: All patients undergoing a Glenn procedure between January 2010 and July 2015 were included in this retrospective cohort study. Demographic data were examined. Standard descriptive statistics was used. A univariable analysis was conducted using the appropriate test based on data distribution. A propensity score for balancing the group difference was included in the multi-variable analysis, which was then completed using predictors from the univariable analysis that achieved significance of p<0.1.<br />Results: Over the study period, 50 patients met the inclusion criteria. Patients were separated into two cohorts of ⩾4 months (28 patients) and <4 months (22 patients). Other than height and weight, the two cohorts were indistinguishable in their pre-operative saturation, medications, catheterisation haemodynamics, atrioventricular valve regurgitation, and ventricular function. After adjusting group differences, younger age was associated with longer post-operative length of hospitalisation - adjusted mean 15 (±2.53) versus 8 (±2.15) days (p=0.03). In a multi-variable regression analysis, in addition to ventricular dysfunction (β coefficient=8.8, p=0.05), Glenn procedures performed before 4 months were independently associated with longer length of stay (β coefficient=-6.9, p=0.03).<br />Conclusion: We found that Glenn procedures performed after 4 months of age had shorter post-operative length of stay when compared to a younger cohort. These findings suggest that balancing timing of surgery to decrease the inter-stage period should take into consideration differences in post-operative recovery with earlier operations.

Details

Language :
English
ISSN :
1467-1107
Volume :
29
Issue :
3
Database :
MEDLINE
Journal :
Cardiology in the young
Publication Type :
Academic Journal
Accession number :
30698131
Full Text :
https://doi.org/10.1017/S1047951118002470