Dorobantu, Dan-Mihai;
Huang, Qi;
Pujol, Ferran Espuny;
Brown, Katherine L;
Franklin, Rodney C;
Pufulete, Maria;
Lawlor, Deborah A;
... Stoica, Serban C; + view all
(2023)
Hospital resource utilization in a national cohort of functionally single ventricle patients undergoing surgical treatment.
JTCVS Open
10.1016/j.xjon.2023.03.014.
(In press).
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Abstract
Objective: To provide a detailed overview of health resource utilization from birth to 18 years old for functionally single ventricle (f-SV) patients and identify associated risk factors./ Methods: All f-SV patients treated between 2000-2017 in England and Wales were linked to hospital and outpatient records using data from the Linking AUdit and National datasets in Congenital HEart Services (LAUNCHES) project. Hospital stay was described in yearly age intervals and associated risk factors were explored using quantile regression./ Results: A total of 3,037 f-SV patients were included, 1409 (46.3%) undergoing a Fontan procedure. During the first year of life the median days spent in-hospital was 60 (IQR 37-102), mostly inpatient days, mirroring a mortality of 22.8%. This decreases to between 2-9 in-hospital days/year afterwards. Between 2-18 years most hospital days were outpatient, with a median of 1-5 days/year./ Lower age at the first procedure, hypoplastic left heart syndrome/mitral atresia, unbalanced atrioventricular septal defect, preterm birth, congenital/acquired comorbidities, additional cardiac risk factors and severity of illness markers were associated with fewer days-at-home and more ICU days in the first year of life. Only markers of early severe illness were associated with fewer days-at-home in the first 6 months post Fontan procedure./ Conclusions: Hospital resource utilization in f-SV is not uniform, decreasing tenfold during adolescence compared to the first year of life. There are subsets of patients with worse outcomes during their first year of life, or with persistently high hospital usage throughout their childhood, which could be the target of future research.
| Type: | Article |
|---|---|
| Title: | Hospital resource utilization in a national cohort of functionally single ventricle patients undergoing surgical treatment |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.xjon.2023.03.014 |
| Publisher version: | https://doi.org/10.1016/j.xjon.2023.03.014 |
| Language: | English |
| Additional information: | © The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | single ventricle, Norwood, Fontan, hospital length of stay, registry, hospital resources, hypoplastic left heart syndrome |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics > Clinical Operational Research Unit |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10168257 |
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