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Outcomes of Truncus Arteriosus Repair and Predictors with Mortality
  • +2
  • Mohammed Hamzah,
  • Hasan F. OthmanOrcid,
  • Kshama Daphtary,
  • Rukmini Komarlu,
  • Hany Aly
Mohammed Hamzah
Cleveland Clinic Children's Hospital
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Hasan F. Othman
Orcid
Sparrow Health System
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Kshama Daphtary
Cleveland Clinic Children's Hospital
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Rukmini Komarlu
Cleveland Clinic Children's Hospital
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Hany Aly
Cleveland Clinic Children's Hospital
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Peer review status:ACCEPTED

15 Apr 2020Submitted to Journal of Cardiac Surgery
15 Apr 2020Submission Checks Completed
15 Apr 2020Assigned to Editor
15 Apr 2020Reviewer(s) Assigned
28 Apr 2020Review(s) Completed, Editorial Evaluation Pending
29 Apr 2020Editorial Decision: Revise Minor
15 May 20201st Revision Received
16 May 2020Submission Checks Completed
16 May 2020Assigned to Editor
17 May 2020Reviewer(s) Assigned
26 May 2020Review(s) Completed, Editorial Evaluation Pending
27 May 2020Editorial Decision: Accept

Abstract

Abstract: The objective of this study was to identify patient and hospitalization characteristics associated with in-hospital mortality in infants with truncus arteriosus. We conducted a retrospective analysis of a large administrative database, the National Inpatient Sample dataset of the Healthcare Cost and Utilization Project for the years 2002-2017. We also sought to evaluate the resource utilization in the subgroup of subjects with truncus arteriosus and 22q11.2 deletion syndrome. Neonates with truncus arteriosus were identified by ICD-9 and ICD-10 codes. Hospital and patient factors associated with inpatient mortality were analyzed. Overall, 3009 neonates met inclusion criteria; a total of 326 patients died during the hospitalization (10.8%). Extracorporeal membrane oxygenation utilization was 7.1 %. Univariate and multivariate logistic regression analyses were used to identify risk factors for in-hospital mortality. Independent risk factors for mortality were prematurity (aOR = 2.43, 95% CI: 1.40–4.22, p = 0.002), diagnosis of stroke (aOR = 26.2, 95% CI: 10.1–68.1, p < 0.001), necrotizing enterocolitis (aOR= 3.10, 95% CI: 1.24-7.74, p=0.015) and presence of venous thrombosis (aOR = 13.5, 95% CI: 6.7–27.2, p < 0.001). Patients who received ECMO support or had cardiac catheterization procedure during the hospitalization had increased odds of mortality (aOR = 82.0, 95% CI: 44.5–151.4, p < 0.001, and aOR = 1.65, 95% CI: 0.98–2.77, p = 0.060, respectively). 22q11.2 deletion syndrome was associated with an inverse risk of death despite having more non-cardiac comorbidities; this patient subpopulation also had higher length of stay and increased cost of hospitalization.