Analysis of factors associated with prolonged post-operative course after surgical repair of aortic coarctation. (3rd February 2021)

• Record Type: Journal Article
• Authors: Kaipa, Santosh; Yabrodi, Mouhammad; Benneyworth, Brian D.; Ebenroth, Eric S.; Mastropietro, Christopher W.
• Is Part Of: Cardiology in the young. Volume 31:Number 2(2021)
• Page Start: 191
• Page End: 198
• Publication Date: 2021-02-03
• Subjects: Aortic coarctation, -- enteral feeding, -- infant, -- newborn, -- length of stay, -- post-operative period, -- risk factors; Pediatric cardiology -- Periodicals; 618.9212
• DOI: 10.1017/S1047951120003637
• Languages: English
• ISSNs: 1047-9511

Abstract

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.