For a study, researchers sought to assess outcomes in children with congenital heart disease (CHD) having noncardiac surgery based on the presence of chronic illnesses and to identify risk factors related with these disorders. In the 2016 Healthcare Cost and Utilization Project Kid’s Inpatient Database, 14 031 children with CHD received noncardiac surgery. The patient and hospital parameters related to in-hospital mortality and length of stay (LOS) were assessed using multivariable regression.
In all, 94% had at least one chronic illness. The rate of in-hospital death was 5.6%. Neonates with CHD had the greatest mortality rate (15.6%); otherwise, children with CHD and at least one chronic ailment had a higher mortality rate than patients with CHD solely (infant 3.93%, child 1.22%, adolescent 1.04% vs 2.34%, 0%, and 0%). Increased mortality was associated with neonates (OR, 15.5; 95% CI, 7.1-34.1 vs adolescent), the number of chronic conditions (OR, 1.34; 95% CI, 1.27-1.42), the type of chronic conditions (circulatory system; OR 2.46; 95% CI, 2.04-2.98), and low socioeconomic status (OR, 1.36; 95% CI, 1.05-1.77). The average length of stay was 20 days (IQR, 5-66). Those who had CHD and at least one chronic disease had a longer LOS (21 days; IQR, 5-68) than those who simply had CHD (9 days; IQR, 3-46). A longer LOS was associated with neonates (adjusted coefficient, 44.3; 95% CI, 40.3-48.3 vs adolescents), Black race (adjusted coefficient, 4.78; 95% CI, 2.27-7.3), chronic condition indicator number (adjusted coefficient, 5.17; 95% CI, 4.56-578), and subtype (adjusted coefficient, 23.6; 95% CI, 20.4-26.7). The majority of children with CHD who receive noncardiac surgery have at least one chronic disease. Age, the number and kind of chronic illnesses, poor socioeconomic level, and race all raise the risk of in-hospital death and length of stay. Additional study is required to assess the impact of specific chronic illnesses and identify impediments to fair care.
Reference:www.jpeds.com/article/S0022-3476(22)00017-8/fulltext
