Congenital Heart Disease in Children
Conditions
Keywords
Perioperative risk prediction, Adverse Postoperative Outcomes
Brief summary
The incidence of moderate to severe congenital heart disease (CHD) in the United States is estimated to be 6 per 1000 live-born full term infants. Recent advances in pediatric cardiology, surgery and critical care have significantly improved the survival rates of patients with CHD leading to an increase in prevalence in both children and adults. Children with CHD significant enough to require cardiac surgery frequently also undergo non-cardiac surgical procedures. Analysis of the Pediatric Health Information System database between 2004 and 2012 demonstrated that 41% of children who had undergone surgery to correct CHD in the first year of life also underwent at least one non-cardiac surgery by age 5. With this increased demand for non-cardiac procedures, anesthesiologists, pediatricians and other healthcare providers will encounter patients with repaired or unrepaired CHD and other cardiac diseases in their practice. However, the information provided by national databases lack granularity and the information from single institutional data is limited. This project aims to address this knowledge gap in quantifying the risk for cardiac patients coming for noncardiac procedures and identify the health care resource utilization and system to best care for this patient population. To conduct this study, we will create a multi-institutional collaboration between large and small centers to create a unique dataset spanning all the different variables that need to be considered in risk prediction for these patients including patient variables, hospital setting, and providers. The aggregate multiinstitutional data set may be used for benchmarking for national quality improvement efforts.
Interventions
OTHERNo intervention. It is observational
No intervention. It is observational
Sponsors
Boston Children's Hospital
The Hospital for Sick Children
Vanderbilt University Medical Center
University of Minnesota
Children's Hospital of Philadelphia
Children's Healthcare of Atlanta
Baylor College of Medicine
Children's National Research Institute
Children's Hospital of The King's Daughters
University of California, Los Angeles
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 21 Years
Healthy volunteers
No
Inclusion criteria
1. Males or females ages birth to 21 years. 2. Patients diagnosed with congenital heart disease 3. Patients undergoing a noncardiac procedure (surgical or nonsurgical)
Exclusion criteria
1. Patients with congenial heart disease undergoing a cardiac surgical procedure including pacemakers. 2. Patients with congenital heart disease undergoing a catheterization(diagnostic or interventional) or an electrophysiology study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | during the procedure and up to 30-days following the procedure | Death |
| Intensive Care Unit admission | following the procedure and up to 72 hours | The postoperative location of the patient is in the intensive care unit unexpectedly |
| Postoperative mechanical support | following the procedure and up to 72 hours | Patient required a ventilator or noninvasive positive pressure ventilation |
| Intraoperative cardiac event | During the perioperative period | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Readmission Cardiac arrest: during the procedure and up to 72 hours Neurologic injury (stroke, seizure) following the procedure and up to 72 hours Renal injury following the procedure and up to 72 hours | following the procedure and up to 72 hours | Patient was discharged after the procedure and needed to be readmitted to the hospital is defined as readmission |
| Cardiac arrest | during the procedure and up to 72 hours | Patient required cardiopulmonary ressuscitation |
| Neurologic injury | Following the procedure and up to 72 hours | Defined as stroke or seizure by the provider |
| Renal Injury | Following the procedure and up to 72 hours | Defined based on creatinine and glomerular filtration |
Countries
Canada, United States
Contacts
CONTACTViviane Nasr, MD
CONTACTRachel Bernier
PRINCIPAL_INVESTIGATORViviane Nasr, MD
Boston Children's Hospital
Outcome results
None listed