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

CARDIOLOGY IN THE YOUNG(2019)

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摘要
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. 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. 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 (beta coefficient = 8.8, p = 0.05), Glenn procedures performed before 4 months were independently associated with longer length of stay (beta coefficient = - 6.9, p = 0.03). 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.
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关键词
CHD,hypoplastic left heart syndrome,Glenn,bidirectional cavopulmonary anastomosis,length of stay,congenital cardiac surgery
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