TY - JOUR
T1 - Complications after the Norwood operation
T2 - An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database
AU - Hornik, Christoph P.
AU - He, Xia
AU - Jacobs, Jeffrey P.
AU - Li, Jennifer S.
AU - Jaquiss, Robert D B
AU - Jacobs, Marshall L.
AU - O'Brien, Sean M.
AU - Peterson, Eric D.
AU - Pasquali, Sara K.
N1 - Funding Information:
Dr Pasquali received grant support from the National Heart, Lung, and Blood Institute (1K08HL103631-01) .
Funding Information:
This study was supported by an American Heart Association Mid-Atlantic Affiliate Clinical Research Award (Sara Pasquali), and a Thrasher Research Fund Early Career Award (Christoph Hornik).
PY - 2011/11
Y1 - 2011/11
N2 - Background: Limited multicenter data exist regarding the prevalence of postoperative complications after the Norwood operation and their associated mortality risk. Methods: We evaluated infants in The Society of Thoracic Surgeons Congenital Heart Surgery Database who underwent the Norwood operation from 2000 to 2009. The prevalence of postoperative complications after the Norwood operation and associated in-hospital mortality were described. Patient factors associated with complications were evaluated in multivariable analyses. Results: A total of 2,557 patients from 53 centers were included. Median age at operation was 6 days (interquartile range, 4 to 9 days) and 90% had a right dominant ventricle. Overall mortality was 22%, and 75% had 1 complication or more. Mortality increased with increasing number of complications: 1 complication, 17%; 2 complications, 21%; 3 complications, 26%; 4 complications, 33%; and 5 or more complications, 45%. Renal and cardiovascular complications carried the greatest mortality risk. Patient factors associated with 1 complication or more included weight less than 2.5 kg (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.2 to 2.1), single right versus single left ventricle (OR, 1.4; 95% CI, 1.01 to 2.0), preoperative shock (OR, 1.5; 95% CI, 1.1 to 2.1), noncardiac/genetic abnormality (OR, 1.5; 95% CI, 1.2 to 1.9), and preoperative mechanical ventilatory (OR, 1.3; 95% CI, 1.03 to 1.6) or circulatory (OR 4.0; 95%CI, 1.6 to 10.2) support. Conclusions: Complications after the Norwood operation are common, carry significant mortality risk, and are associated with several preoperative patient characteristics. These data may aid in providing prognostic information to families and in guiding quality improvement initiatives.
AB - Background: Limited multicenter data exist regarding the prevalence of postoperative complications after the Norwood operation and their associated mortality risk. Methods: We evaluated infants in The Society of Thoracic Surgeons Congenital Heart Surgery Database who underwent the Norwood operation from 2000 to 2009. The prevalence of postoperative complications after the Norwood operation and associated in-hospital mortality were described. Patient factors associated with complications were evaluated in multivariable analyses. Results: A total of 2,557 patients from 53 centers were included. Median age at operation was 6 days (interquartile range, 4 to 9 days) and 90% had a right dominant ventricle. Overall mortality was 22%, and 75% had 1 complication or more. Mortality increased with increasing number of complications: 1 complication, 17%; 2 complications, 21%; 3 complications, 26%; 4 complications, 33%; and 5 or more complications, 45%. Renal and cardiovascular complications carried the greatest mortality risk. Patient factors associated with 1 complication or more included weight less than 2.5 kg (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.2 to 2.1), single right versus single left ventricle (OR, 1.4; 95% CI, 1.01 to 2.0), preoperative shock (OR, 1.5; 95% CI, 1.1 to 2.1), noncardiac/genetic abnormality (OR, 1.5; 95% CI, 1.2 to 1.9), and preoperative mechanical ventilatory (OR, 1.3; 95% CI, 1.03 to 1.6) or circulatory (OR 4.0; 95%CI, 1.6 to 10.2) support. Conclusions: Complications after the Norwood operation are common, carry significant mortality risk, and are associated with several preoperative patient characteristics. These data may aid in providing prognostic information to families and in guiding quality improvement initiatives.
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U2 - 10.1016/j.athoracsur.2011.05.100
DO - 10.1016/j.athoracsur.2011.05.100
M3 - Article
C2 - 21937021
AN - SCOPUS:80155181458
SN - 0003-4975
VL - 92
SP - 1734
EP - 1740
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -