PDF(Pubmed)
Abstract：
UNASSIGNED: For infants with single ventricle heart disease, the time after stage 2 procedure (S2P) is believed to be a lower risk period compared with the interstage period; however, significant morbidity and mortality still occur.
UNASSIGNED: This study aimed to identify risk factors for mortality or transplantation referral between S2P surgery and the first birthday.
UNASSIGNED: Retrospective cohort analysis of infants in the National Pediatric Cardiology Quality Improvement Collaborative who underwent staged single ventricle palliation from 2016 to 2022 and survived to S2P. Multivariable logistic regression and classification and regression trees were performed to identify risk factors for mortality and transplantation referral after S2P.
UNASSIGNED: Of the 1,455 patients in the cohort who survived to S2P, 5.2% died and 2.3% were referred for transplant. Overall event rates at 30 and 100 days after S2P were 2% and 5%, respectively. Independent risk factors for mortality and transplantation referral included the presence of a known genetic syndrome, shunt type at stage 1 procedure (S1P), tricuspid valve repair at S1P, longer time to extubation and reintubation after S1P, ≥ moderate tricuspid regurgitation prior to S2P, younger age at S2P, and the risk groups identified in the classification and regression tree analysis (extracorporeal membrane oxygenation after S1P and longer S2P cardiopulmonary bypass time without extracorporeal membrane oxygenation).
UNASSIGNED: Mortality and transplantation referral rates after S2P to 1 year of age remain high ∼7%. Many of the identified risk factors after S2P are similar to those established for interstage factors around the S1P, whereas others may be unique to the period after S2P.
UNASSIGNED: This study aimed to identify risk factors for mortality or transplantation referral between S2P surgery and the first birthday.
UNASSIGNED: Retrospective cohort analysis of infants in the National Pediatric Cardiology Quality Improvement Collaborative who underwent staged single ventricle palliation from 2016 to 2022 and survived to S2P. Multivariable logistic regression and classification and regression trees were performed to identify risk factors for mortality and transplantation referral after S2P.
UNASSIGNED: Of the 1,455 patients in the cohort who survived to S2P, 5.2% died and 2.3% were referred for transplant. Overall event rates at 30 and 100 days after S2P were 2% and 5%, respectively. Independent risk factors for mortality and transplantation referral included the presence of a known genetic syndrome, shunt type at stage 1 procedure (S1P), tricuspid valve repair at S1P, longer time to extubation and reintubation after S1P, ≥ moderate tricuspid regurgitation prior to S2P, younger age at S2P, and the risk groups identified in the classification and regression tree analysis (extracorporeal membrane oxygenation after S1P and longer S2P cardiopulmonary bypass time without extracorporeal membrane oxygenation).
UNASSIGNED: Mortality and transplantation referral rates after S2P to 1 year of age remain high ∼7%. Many of the identified risk factors after S2P are similar to those established for interstage factors around the S1P, whereas others may be unique to the period after S2P.
摘要：
■对于患有单心室心脏病的婴儿，与间期相比，第2阶段手术（S2P）后的时间被认为是较低的风险期；但是，显著的发病率和死亡率仍然存在。
■本研究旨在确定S2P手术与1岁生日之间死亡或移植转诊的危险因素。
■在2016年至2022年期间接受了阶段性单心室姑息治疗并存活至S2P的国家儿科心脏病学质量改进合作组织中的婴儿的回顾性队列分析。进行多变量逻辑回归和分类和回归树，以确定S2P后死亡率和移植转诊的危险因素。
■在该队列中存活到S2P的1,455名患者中，5.2%死亡，2.3%转诊接受移植。S2P后30天和100天的总体事件发生率分别为2％和5％，分别。死亡率和移植转诊的独立危险因素包括已知遗传综合征的存在，第1阶段程序(S1P)中的分流类型,S1P三尖瓣修复,S1P后拔管和再插管的时间更长，S2P前≥中度三尖瓣反流，在S2P年龄较小，和分类和回归树分析中确定的风险组（S1P后的体外膜氧合和无体外膜氧合的更长的S2P体外循环时间）。
■S2P至1岁后的死亡率和移植转诊率仍然很高~7%。S2P后的许多已确定的风险因素与S1P周围的阶段间因素相似，而其他人可能是S2P之后的独特时期。
■本研究旨在确定S2P手术与1岁生日之间死亡或移植转诊的危险因素。
■在2016年至2022年期间接受了阶段性单心室姑息治疗并存活至S2P的国家儿科心脏病学质量改进合作组织中的婴儿的回顾性队列分析。进行多变量逻辑回归和分类和回归树，以确定S2P后死亡率和移植转诊的危险因素。
■在该队列中存活到S2P的1,455名患者中，5.2%死亡，2.3%转诊接受移植。S2P后30天和100天的总体事件发生率分别为2％和5％，分别。死亡率和移植转诊的独立危险因素包括已知遗传综合征的存在，第1阶段程序(S1P)中的分流类型,S1P三尖瓣修复,S1P后拔管和再插管的时间更长，S2P前≥中度三尖瓣反流，在S2P年龄较小，和分类和回归树分析中确定的风险组（S1P后的体外膜氧合和无体外膜氧合的更长的S2P体外循环时间）。
■S2P至1岁后的死亡率和移植转诊率仍然很高~7%。S2P后的许多已确定的风险因素与S1P周围的阶段间因素相似，而其他人可能是S2P之后的独特时期。
