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Gastrostomy tube placement in congenital cardiac surgery: a multi-institutional database study

Published online by Cambridge University Press:  03 October 2022

Brena S. Haughey Open the ORCID record for Brena S. Haughey [Opens in a new window] ,
Peter Dean ,
Michael C. Spaeder ,
Clyde J. Smith ,
Mark Conaway  and
Shelby C. White
Brena S. Haughey
Affiliation:
Department of Pediatrics (Cardiology), University of Virginia, Charlottesville, VA, USA
Peter Dean
Affiliation:
Department of Pediatrics (Cardiology), University of Virginia, Charlottesville, VA, USA
Michael C. Spaeder
Affiliation:
Department of Pediatrics (Critical Care), University of Virginia, Charlottesville, VA, USA
Clyde J. Smith
Affiliation:
Department of Pediatrics (Cardiology), University of Virginia, Charlottesville, VA, USA Department of Pediatrics (Critical Care), University of Virginia, Charlottesville, VA, USA
Mark Conaway
Affiliation:
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
Shelby C. White*
Affiliation:
Department of Pediatrics (Cardiology), University of Virginia, Charlottesville, VA, USA
*
Author for correspondence: Shelby C. White, MD, 1204 W. Main St., Charlottesville, VA 22903, USA. Tel: +1 434 924 9119; Fax: +1 434 924 5656. E-mail: SW2BD@hscmail.mcc.virginia.edu
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Abstract

Introduction:

Neonates and infants who undergo congenital cardiac surgery frequently have difficulty with feeding. The factors that predispose these patients to require a gastrostomy tube have not been well defined. We aimed to report the incidence and describe hospital outcomes and characteristics in neonates and infants undergoing congenital cardiac surgery who required gastrostomy tube placement.

Materials and method:

A retrospective review was performed on patients undergoing congenital cardiac surgery between October 2015 and December 2020. Patients were identified by International Classification of Diseases 10th Revision codes, utilising the performance improvement database Vizient® Clinical Data Base, and stratified by age at admission: neonates (<1 month) and infants (1–12 months). Outcomes were compared and comparative analysis performed between admissions with and without gastrostomy tube placement.

Results:

There were 11,793 admissions, 3519 (29.8%) neonates and 8274 (70.2%) infants. We found an increased incidence of gastrostomy tube placement in neonates as compared to infants following congenital cardiac surgery (23.1% versus 6%, p = <0.001). Outcomes in neonates and infants were similar with increased length of stay and cost in those requiring a gastrostomy tube. Gastrostomy tube placement was noted to be more likely in neonates and infants with upper airway anomalies, congenital abnormalities, hospital infections, and genetic abnormalities.

Discussion:

Age at hospitalisation for congenital cardiac surgery is a definable risk factor for gastrostomy tube requirement. Additional factors contribute to gastrostomy tube placement and should be used when counselling families regarding the potential requirement of a gastrostomy tube.

Keywords

CHDcardiac surgeryoutcomes
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 9 , September 2023 , pp. 1672 - 1677
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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Footnotes

Social Media Synopsis: Neonates nearly four times as likely to require gastrostomy tube placement than infants requiring congenital cardiac surgery. #CHD #CardiologyYoung

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