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Analysis of factors associated with prolonged post-operative course after surgical repair of aortic coarctation

Published online by Cambridge University Press:  03 November 2020

Santosh Kaipa Open the ORCID record for Santosh Kaipa [Opens in a new window] ,
Mouhammad Yabrodi ,
Brian D. Benneyworth ,
Eric S. Ebenroth  and
Christopher W. Mastropietro
Santosh Kaipa*
Affiliation:
Department of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
Mouhammad Yabrodi
Affiliation:
Department of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
Brian D. Benneyworth
Affiliation:
Department of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
Eric S. Ebenroth
Affiliation:
Department of Pediatrics, Division of Cardiology, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
Christopher W. Mastropietro
Affiliation:
Department of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
*
Author for correspondence: Santosh Kaipa, MD, MS, Department of Pediatrics, Division of Critical Care Medicine, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Drive, Phase 2, Rm 4911A, Indianapolis, IN 46202, USA. Tel: +1 317 944 1610; Fax: +1 317 944 3442. E-mail: santoshkaipa@gmail.com
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Abstract

Objective:

We sought to describe patient characteristics associated with prolonged post-operative length of stay in a contemporary cohort of infants who underwent isolated repair of aortic coarctation.

Methods:

We reviewed patients less than 1 year of age who underwent isolated repair of aortic coarctation at our institution from 2009 to 2016. Prolonged post-operative length of stay was defined as length of stay within the upper tertile for the cohort. Bivariate and multi-variable analyses were performed to determine independent risk factors for prolonged length of stay.

Results:

We reviewed 95 consecutive patients who underwent isolated repair of aortic coarctation, of whom 71 were neonates at the time of diagnosis. The median post-operative length of stay was 6.5 days. The upper tertile for post-operative length of stay was greater than 10 days; 32 patients within this tertile and 1 patient who died at 8.5 days after surgery were analysed as having prolonged post-operative length of stay. In a multi-variable analysis, pre-maturity (odds ratio: 3.5, 95% confidence interval: 1.2, 10.7), genetic anomalies (odds ratio: 4.7, 95% confidence interval: 1.2, 18), absence of pre-operative oral feeding (odds ratio: 7.4, 95% confidence interval: 2.4, 22.3), and 12-hour vasoactive-ventilation-renal score greater than 25 (odds ratio: 7.4, 95% confidence interval: 1.9, 29) were independently associated with prolonged length of stay.

Conclusions:

In neonates and infants who underwent isolated repair of aortic coarctation, pre-maturity, genetic anomalies, lack of pre-operative oral feedings, and 12-hour vasoactive-ventilation-renal score more than 25 were independent risk factors for prolonged post-operative length of stay. Further study on the relationship between pre-operative oral feedings and post-operative length of stay should be pursued.

Keywords

Aortic coarctationenteral feedinginfantnewbornlength of staypost-operative periodrisk factors
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 2 , February 2021 , pp. 191 - 198
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

The results in this manuscript were presented in abstract form at Neoheart 2018, the annual meeting of the Neonatal Heart Society, Fort Worth, TX, March, 2018.

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