PMID- 32621963
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210630
IS  - 1532-9488 (Electronic)
IS  - 1043-0679 (Linking)
VI  - 32
IP  - 4
DP  - 2020 Winter
TI  - An Analysis of Hospital Mortality After Cardiac Operations in Children With Down 
      Syndrome.
PG  - 947-957
LID - S1043-0679(20)30228-8 [pii]
LID - 10.1053/j.semtcvs.2020.06.037 [doi]
AB  - Children with Down syndrome (DS) have lower mortality compared to nonsyndromic 
      (NS) children after atrioventricular septal defect (AVSD) repair. Limited data 
      exist regarding hospital mortality and utilization after other congenital heart 
      disease (CHD) operations in DS. We compared hospital mortality and utilization 
      after CHD operations in both populations and hypothesized that the survival 
      benefit in children with DS is not consistent across CHD lesions. The Texas 
      Inpatient Public Use Datafile was queried for all patients <18 years old 
      undergoing operations for CHD between 1999 and 2016. Hospital mortality, 
      length-of-stay and charges were compared between DS and NS groups, stratified by 
      CHD operation using mixed-effects multivariable analyses and propensity score 
      matching analyses adjusting for prematurity, low birth weight, age, and sex. Over 
      the 18-year period, 2841 cases with DS underwent CHD operations compared to 
      25,063 NS cases. The most common types of interventions performed in DS were AVSD 
      repair, isolated ventricular septal defect (VSD) repair and tetralogy of Fallot 
      (TOF) repair. By multivariable analyses, DS was associated with lower mortality 
      after isolated AVSD repair (RR 0.40 [IQR 0.20-0.79]), and higher hospital 
      mortality after bidirectional Glenn anastomosis (BDG) (RR 5.17 [IQR 2.10-12.77]) 
      and TOF/pulmonary atresia repair (RR 9.71 [IQR 2.16-43.68]) compared to NS 
      children. Similar results were noted using propensity score matching. Children 
      with DS had lower mortality after AVSD repair than NS children, but higher 
      mortality after operations for BDG and TOF/pulmonary atresia. Further study is 
      needed to determine if the presence of pulmonary hypertension in DS modifies the 
      association between DS and mortality depending on cardiac lesion.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Dhillon, Gurpreet S
AU  - Dhillon GS
AD  - Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical 
      School and Boston Children's Hospital, Boston, Massachusetts. Electronic address: 
      garydhillon629@gmail.com.
FAU - Ghanayem, Nancy S
AU  - Ghanayem NS
AD  - Section of Critical Care Medicine, Department of Pediatrics, Baylor College of 
      Medicine and Texas Children's Hospital, Houston, Texas.
FAU - Broda, Christopher R
AU  - Broda CR
AD  - Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor 
      College of Medicine and Texas Children's Hospital, Houston, Texas.
FAU - Lalani, Seema R
AU  - Lalani SR
AD  - Department of Molecular and Human Genetics, Baylor College of Medicine and Texas 
      Children's Hospital, Houston, Texas.
FAU - Mery, Carlos M
AU  - Mery CM
AD  - Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell 
      Medical School and Dell Children's Medical Center, Austin, Texas.
FAU - Shekerdemian, Lara S
AU  - Shekerdemian LS
AD  - Section of Critical Care Medicine, Department of Pediatrics, Baylor College of 
      Medicine and Texas Children's Hospital, Houston, Texas.
FAU - Staffa, Steven J
AU  - Staffa SJ
AD  - Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical 
      School and Boston Children's Hospital, Boston, Massachusetts.
FAU - Morris, Shaine A
AU  - Morris SA
AD  - Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor 
      College of Medicine and Texas Children's Hospital, Houston, Texas.
LA  - eng
PT  - Journal Article
DEP - 20200702
PL  - United States
TA  - Semin Thorac Cardiovasc Surg
JT  - Seminars in thoracic and cardiovascular surgery
JID - 8917640
SB  - IM
CIN - Semin Thorac Cardiovasc Surg. 2021 Summer;33(2):515-516. PMID: 32846231
CIN - Semin Thorac Cardiovasc Surg. 2020 Winter;32(4):958-959. PMID: 32882396
MH  - Adolescent
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Child
MH  - *Down Syndrome/complications/diagnosis
MH  - *Heart Defects, Congenital/diagnosis/surgery
MH  - Hospital Mortality
MH  - Humans
MH  - Infant
MH  - Retrospective Studies
MH  - Texas
OTO - NOTNLM
OT  - Atrioventricular canal defect
OT  - Atrioventricular septal defect
OT  - Cardiac operations
OT  - Cardiac surgery
OT  - Congenital heart disease
OT  - Down syndrome
OT  - Mortality
OT  - Trisomy 21
EDAT- 2020/07/06 06:00
MHDA- 2021/04/28 06:00
CRDT- 2020/07/05 06:00
PHST- 2020/06/18 00:00 [received]
PHST- 2020/06/27 00:00 [accepted]
PHST- 2020/07/06 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2020/07/05 06:00 [entrez]
AID - S1043-0679(20)30228-8 [pii]
AID - 10.1053/j.semtcvs.2020.06.037 [doi]
PST - ppublish
SO  - Semin Thorac Cardiovasc Surg. 2020 Winter;32(4):947-957. doi: 
      10.1053/j.semtcvs.2020.06.037. Epub 2020 Jul 2.