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Association of Interstage Home Monitoring With Mortality, Readmissions, and Weight Gain
- Source :
- Circulation. 132:502-508
- Publication Year :
- 2015
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2015.
-
Abstract
- Background— Daily home monitoring of oxygen saturation and weight has been reported to improve outcomes for patients with single-ventricle heart disease during the period between stage I palliation and stage II palliation. However, these studies have been limited to single institutions and used historical control subjects. Our objective was to determine the association of various interstage home monitoring strategies with outcomes using a multicenter cohort with contemporary control subjects. Methods and Results— We performed a retrospective cohort study using prospectively collected data from the National Pediatric Cardiology Quality Improvement Collaborative from 2008 to 2012. We compared interstage mortality, unscheduled readmissions, and change in weight-for-age Z score for various home monitoring strategies of oxygen saturation (n=494) or weight (n=472), adjusting for sex, syndrome, tricuspid regurgitation, arch obstruction, and shunt type. Overall interstage mortality was 8.1%, and 47% had ≥1 unscheduled readmission. We did not find any associations of home oxygen saturation or weight monitoring with mortality or readmission. Although there was no difference in weight-for-age Z score for daily (0.33±0.12) versus weekly (0.34±0.18, P =0.98) weight monitoring, daily home weight monitoring was superior to no home weight monitoring (−0.15±0.18; P Conclusions— Home weight monitoring is associated with improved weight gain during the interstage period, but we did not find any benefits in other clinical outcomes for either home oxygen saturation monitoring or home weight monitoring.
- Subjects :
- Heart Defects, Congenital
Male
medicine.medical_specialty
Time Factors
Heart disease
Home Nursing
Heart Ventricles
Partial Pressure
medicine.medical_treatment
Standard score
Norwood Procedures
Weight Gain
Patient Readmission
Hypoplastic left heart syndrome
Physiology (medical)
Hypoplastic Left Heart Syndrome
medicine
Humans
Oximetry
Hypoxia
Intensive care medicine
Blalock-Taussig Procedure
Retrospective Studies
Oxygen saturation (medicine)
Cyanosis
Postoperative Care
business.industry
Body Weight
Infant
Retrospective cohort study
medicine.disease
Quality Improvement
Oxygen
Treatment Outcome
Emergency medicine
Cohort
Female
Norwood procedure
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Weight gain
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 132
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....8819b7531ea2b66af9f0cfba90c6637f