Increased mortality, morbidities, and costs after heart transplantation in heterotaxy syndrome and other complex situs arrangements
被引:16
作者:
Duong, Son Q.
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机构:
Univ Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Duong, Son Q.
[1
]
Godown, Justin
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h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Cardiothorac Surg, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Godown, Justin
[2
]
Soslow, Jonathan H.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Cardiothorac Surg, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Soslow, Jonathan H.
[2
]
Thurm, Cary
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Clin & Translat Sci, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Thurm, Cary
[3
]
Hall, Matt
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h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Clin & Translat Sci, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Hall, Matt
[3
]
Sainathan, Sandeep
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h-index: 0
机构:
Monroe Carell Jr Childrens Hosp Vanderbilt, Div Pediat Cardiol, Nashville, TN USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Sainathan, Sandeep
[4
]
Morell, Victor O.
论文数: 0引用数: 0
h-index: 0
机构:
Monroe Carell Jr Childrens Hosp Vanderbilt, Div Pediat Cardiol, Nashville, TN USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Morell, Victor O.
[4
]
Dodd, Debra A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Cardiothorac Surg, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Dodd, Debra A.
[2
]
Feingold, Brian
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Childrens Hosp Assoc, Lenexa, KS USAUniv Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
Feingold, Brian
[1
,5
]
机构:
[1] Univ Pittsburgh, Sch Med, Dept Pediat, 4401 Penn Ave,Fac Pavil Floor 5, Pittsburgh, PA 15224 USA
[2] Univ Pittsburgh, Sch Med, Dept Cardiothorac Surg, Pittsburgh, PA USA
[3] Univ Pittsburgh, Sch Med, Dept Clin & Translat Sci, Pittsburgh, PA USA
[4] Monroe Carell Jr Childrens Hosp Vanderbilt, Div Pediat Cardiol, Nashville, TN USA
Objectives: Identify pediatric heart transplant (HT) recipients with heterotaxy and other complex arrangements of cardiac situs (heterotaxy/situs anomaly) and compare mortality, morbidities, length of stay (LOS), and costs to recipients with congenital heart disease without heterotaxy/situs anomaly. Methods: Using linked registry data (2001-2016), we identified 186 HT recipients with heterotaxy/situs anomaly and 1254 with congenital heart disease without heterotaxy/situs anomaly. We compared post-HT outcomes in univariable and multivariable time-to-event analyses. LOS and cost from HT to discharge were compared using Wilcoxon rank-sum tests. Sensitivity analyses were performed using stricter heterotaxy/situs anomaly group inclusion criteria and through propensity matching. Results: HT recipients with heterotaxy/situs anomaly were older (median age, 5.1 vs 1.6 years; P < .001) and more often black, Asian, Hispanic, or "other'' nonwhite (54% vs 32%; P < .001). Heterotaxy/situs anomaly was independently associated with increased mortality (hazard ratio, 1.58; 95% confidence interval, 1.19-2.09; P = .002), even among 6-month survivors (hazard ratio, 1.86; 95% confidence interval, 1.09-3.16; P = .021). Heterotaxy/situs anomaly recipients more commonly required dialysis (odds ratio, 2.58; 95% confidence interval, 1.51-4.42; P = .001) and cardiac reoperation (odds ratio, 1.91; 95% confidence interval, 1.17-3.11; P = .010) before discharge. They had longer ischemic times (19.2 additional minutes [range, 10.9-27.5 minutes]; P < .001), post-HT intensive care unit LOS (16 vs 13 days; P = .012), and hospital LOS (26 vs 23 days; P = .005). Post-HT hospitalization costs were also greater ($447,604 vs $379,357; P = .001). Conclusions: Heterotaxy and other complex arrangements of cardiac situs are associated with increased mortality, postoperative complications, LOS, and costs after HT. Although increased surgical complexity can account for many of these differences, inferior late survival is not well explained and deserves further study.
机构:
Univ Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Everitt, Melanie D.
;
Pahl, Elfriede
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Childrens Mem Hosp, Feinberg Sch Med, Chicago, IL 60614 USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Pahl, Elfriede
;
Schechtman, Kenneth B.
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Dept Pediat, St Louis, MO 63130 USA
Washington Univ, Dept Biostat, St Louis, MO USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Schechtman, Kenneth B.
;
Zheng, Jie
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Dept Pediat, St Louis, MO 63130 USA
Washington Univ, Dept Biostat, St Louis, MO USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Zheng, Jie
;
Ringewald, Jeremy M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ S Florida, Coll Med, All Childrens Hosp, St Petersburg, FL 33701 USA
Univ S Florida, Coll Med, Childrens Hosp Tampa, St Petersburg, FL 33701 USA
Univ S Florida, Coll Med, All Childrens Hosp, Tampa, FL USA
Univ S Florida, Coll Med, Childrens Hosp Tampa, Tampa, FL USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Ringewald, Jeremy M.
;
Ecuyer, Thomas L'
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h-index: 0
机构:
Wayne State Univ, Childrens Hosp Michigan, Detroit, MI USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Ecuyer, Thomas L'
;
Naftel, David C.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Birmingham, AL USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Naftel, David C.
;
Kirklin, James K.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Birmingham, AL USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Kirklin, James K.
;
Blume, Elizabeth D.
论文数: 0引用数: 0
h-index: 0
机构:
Childrens Hosp Boston, Boston, MA USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Blume, Elizabeth D.
;
Bullock, Emily A.
论文数: 0引用数: 0
h-index: 0
机构:Univ Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Bullock, Emily A.
;
Canter, Charles E.
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Dept Pediat, St Louis, MO 63130 USA
Washington Univ, Dept Biostat, St Louis, MO USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
机构:
Univ Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Everitt, Melanie D.
;
Pahl, Elfriede
论文数: 0引用数: 0
h-index: 0
机构:
Northwestern Univ, Childrens Mem Hosp, Feinberg Sch Med, Chicago, IL 60614 USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Pahl, Elfriede
;
Schechtman, Kenneth B.
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Dept Pediat, St Louis, MO 63130 USA
Washington Univ, Dept Biostat, St Louis, MO USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Schechtman, Kenneth B.
;
Zheng, Jie
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Dept Pediat, St Louis, MO 63130 USA
Washington Univ, Dept Biostat, St Louis, MO USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Zheng, Jie
;
Ringewald, Jeremy M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ S Florida, Coll Med, All Childrens Hosp, St Petersburg, FL 33701 USA
Univ S Florida, Coll Med, Childrens Hosp Tampa, St Petersburg, FL 33701 USA
Univ S Florida, Coll Med, All Childrens Hosp, Tampa, FL USA
Univ S Florida, Coll Med, Childrens Hosp Tampa, Tampa, FL USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Ringewald, Jeremy M.
;
Ecuyer, Thomas L'
论文数: 0引用数: 0
h-index: 0
机构:
Wayne State Univ, Childrens Hosp Michigan, Detroit, MI USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Ecuyer, Thomas L'
;
Naftel, David C.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Birmingham, AL USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Naftel, David C.
;
Kirklin, James K.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Birmingham, AL USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Kirklin, James K.
;
Blume, Elizabeth D.
论文数: 0引用数: 0
h-index: 0
机构:
Childrens Hosp Boston, Boston, MA USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Blume, Elizabeth D.
;
Bullock, Emily A.
论文数: 0引用数: 0
h-index: 0
机构:Univ Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA
Bullock, Emily A.
;
Canter, Charles E.
论文数: 0引用数: 0
h-index: 0
机构:
Washington Univ, Dept Pediat, St Louis, MO 63130 USA
Washington Univ, Dept Biostat, St Louis, MO USAUniv Utah, Div Pediat Cardiol, Primary Childrens Med Ctr, Salt Lake City, UT 84113 USA