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Contemporary risk factors for a longer hospital stay following bidirectional cavopulmonary anastomosis

Published online by Cambridge University Press:  23 August 2022

Saleem I. Almasarweh ,
Patcharapong Suntharos ,
Ashish Saini ,
Lourdes Prieto  and
Jun Sasaki Open the ORCID record for Jun Sasaki [Opens in a new window]
Saleem I. Almasarweh
Affiliation:
Division of Cardiology, Department of Pediatrics, Children’s Healthcare of Atlanta, Atlanta, GE, USA
Patcharapong Suntharos
Affiliation:
Department of Pediatric Cardiology, Cleveland Clinic Children’s, Cleveland, OH, USA
Ashish Saini
Affiliation:
Department of Cardiology, Nicklaus Children’s Hospital, Miami, FL, USA
Lourdes Prieto
Affiliation:
Department of Cardiology, Nicklaus Children’s Hospital, Miami, FL, USA
Jun Sasaki*
Affiliation:
Division of Pediatric Critical Care Medicine, Department of Pediatrics, Weill Cornell Medicine/NewYork-Presbyterian Komansky Children’s Hospital, New York, NY, USA
*
Author for correspondence: Jun Sasaki, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Weill Cornell Medicine, 525 East 68th Street, New York, NY 10065, USA. Tel: +1 212 746 3561; Fax: +1 212 746 8373. E-mail: jus9051@med.cornell.edu
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Abstract

Background:

Despite high survival after bidirectional cavopulmonary anastomosis, a considerable number of patients suffer significant post-operative morbidities related to prolonged length of stay.

Methods:

A single-center retrospective cohort study of all consecutive patients undergoing a first-time bidirectional cavopulmonary anastomosis from 2006 to 2019.

Results:

Prolonged length of stay was defined as hospital stay greater than the 75th percentile for our cohort. Of 195 patients who met inclusion criteria, the median post-operative length of stay was 8 days (interquartile range, 4-15 days). Prolonged length of stay was defined as greater than 15 days. In multivariate analysis, greater than mild systemic atrioventricular valve regurgitation (odds ratio 3.7, 95% CI 1.05-13.068, p = 0.04), longer length of stay after the initial palliative procedure (odds ratio 1.028, 95% CI 1.004-1.05, p = 0.02), and pre-operative higher superior vena cava oxygen saturation (odds ratio 0.922, 95% CI 0.85-0.99, p = 0.04) maintained statistical significance as independent risk and protective factors for prolonged length of stay. A one-level increase in the severity of pre-operative systemic atrioventricular valve regurgitation was associated with a multiplicative change in the odds ratio of prolonged length of stay of 5.45 (p = 0.005) independent of the severity of systemic ventricular dysfunction.

Conclusion:

Pre-operative characteristics with greater than mild systemic atrioventricular valve regurgitation, longer length of stay after the initial palliative procedure, and lower superior vena cava oxygen saturation were associated with prolonged length of stay after a first-time bidirectional cavopulmonary anastomosis.

Keywords

Bidirectional cavopulmonary anastomosissingle ventriclerisk factorslonger hospital staycardiac intensive careatrioventricular valve regurgitation
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 9 , September 2023 , pp. 1529 - 1535
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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