完成左心发育不良综合征的3阶段缓解需要大量资源。尚未对最近的数据进行分析。我们的目的是确定完成所有三个阶段的单心室姑息治疗所需的总费用,包括舞台间的相遇。我们还旨在确定总体资源利用率,包括住院天数,舞台间招生,和中间程序。我们使用2016年至2021年儿科健康信息系统数据库的数据进行了一项回顾性队列研究,包括所有因左心发育不良综合征完成3期缓解的患者。我们确定了199名患者,他们在2016年至2021年之间接受了3期左心发育不良综合征的姑息治疗。总调整费用中位数(四分位数范围,IQR)在三个阶段的缓解过程中为1,475,800美元(1,028,900-2,191,700美元)。第1、2和3阶段住院的中位数调整后费用(IQR)为604,300美元(419,000-891,400美元),234,000美元(164,300-370,800美元),和256,260美元(178,300-345,900美元),分别。第1、2和3阶段的中位住院时间(IQR)为36(26,53),9(6,17),和10(7,14)天,分别。肺动脉狭窄是最常见的分期住院诊断(占住院的3.4%)。心脏导管插入术(占程序的24.1%)和饲管放置(占程序的10.0%)是阶段间住院期间最常见的主要程序。在左心发育不良综合征的三个阶段缓解中,住院总费用是可观的,并且自先前的研究以来一直在增加。胃肠道合并症和喂养优化对这种资源利用有很大贡献。
Completing 3-stage palliation for hypoplastic left heart syndrome requires significant resources. An analysis of recent data has not been performed. We aimed to determine total charges necessary to complete all 3 stages of single-ventricle palliation, including interstage encounters. We also aimed to determine overall resource utilization, including hospital days, interstage admissions, and interstage procedures. We performed a retrospective cohort study using data from the Pediatric Health Information System database between 2016 and 2021, including all patients who completed 3-stage palliation for hypoplastic left heart syndrome. We identified 199 patients who underwent 3-stage palliation of hypoplastic left heart syndrome between 2016 and 2021. Median total adjusted charges (interquartile range, IQR) over the course of 3-stage palliation were $1,475,800 ($1,028,900-2,191,700). Median adjusted charges (IQR) for stage 1, 2, and 3 hospitalizations were $604,300 ($419,000-891,400), $234,000 ($164,300-370,800), and $256,260 ($178,300-345,900), respectively. Median hospital length of stay (IQR) for stages 1, 2, and 3 was 36 (26,53), 9 (6,17), and 10 (7,14) days, respectively. Pulmonary artery stenosis was the most common admitting diagnosis for interstage hospitalizations (3.4% of hospitalizations). Cardiac catheterization (24.1% of procedures) and feeding tube placement (10.0% of procedures) were the most common principal procedures during interstage hospitalizations. Total inpatient charges incurred throughout 3-stage palliation of hypoplastic left heart syndrome are substantial and have risen since prior studies. Gastrointestinal comorbidities and feeding optimization contribute considerably to this resource utilization.