Risk Factors for Higher Cost in Congenital Heart Operations

Ungerleider, Ross M.; Bengur, A. Resai; Kessenich, Amy L; Liekweg, Richard J; Hart, Ellen M.; Rice, Beth Ann; Miller, Coleen E; Lockwood, N.; Knauss, Sheryl A; Jaggers, James; Sanders, Stephen P.; Greeley, William J.

doi:10.1016/s0003-4975(97)00503-1

Cited by 37 publications

(39 citation statements)

References 7 publications

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“…This is consistent with the congenital heart surgery literature 16,17 and other studies that have investigated clinical risk factors associated with higher hospital charges for congenital heart surgery in children. 18,19 It is of interest that Down syndrome in adults was not associated with higher resource utilization, in contrast to findings by Ungerleider in the pediatric population. 19 Instead, we identified DiGeorge syndrome as an independent clinical risk factor associated with HRU.…”

Section: Risk Factors For High Resource Usementioning

confidence: 90%

“…18,19 It is of interest that Down syndrome in adults was not associated with higher resource utilization, in contrast to findings by Ungerleider in the pediatric population. 19 Instead, we identified DiGeorge syndrome as an independent clinical risk factor associated with HRU. DiGeorge syndrome has a wide spectrum of disease severity with multi-organ involvement.…”

Section: Risk Factors For High Resource Usementioning

confidence: 90%

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Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals

Kim

Gauvreau

Bacha

et al. 2011

Circ: Cardiovascular Quality and Outcomes

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Background-Pediatric hospitals frequently perform congenital heart surgery in adults with congenital heart disease. The impact of these admissions on pediatric hospital resources is unknown. Our goals were to examine resource use by adults undergoing congenital heart surgery in pediatric hospitals, explore the association between high resource use (HRU) and inpatient death, and identify HRU risk factors. Methods and Results-We obtained inpatient data from 42 pediatric hospitals from 2000 to 2008 and selected adult congenital heart (ACH) surgery admissions. We defined HRU admissions as those exceeding the 90th percentile for total hospital charges. We performed multivariable analyses using generalized estimating equations to identify risk factors for HRU. Of 97 563 congenital heart surgery admissions to pediatric hospitals, 3061 (3.1%) were adults, accounting for 2.2% of total hospital charges.

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Section: Risk Factors For High Resource Usementioning

confidence: 90%

Section: Risk Factors For High Resource Usementioning

confidence: 90%

Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals

Kim

Gauvreau

Bacha

et al. 2011

Circ: Cardiovascular Quality and Outcomes

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“…Actual hospital costs were calculated for every patient who underwent either of the two procedures used for ASD II closure (22). Our cost-effective analysis compared only the direct costs (patient care related) in relation to the clinical success of the two procedures.…”

Section: Methodsmentioning

confidence: 99%

Surgical Versus Percutaneous Occlusion of Ostium Secundum Atrial Septal Defects

Vida

Barnoya

O'Connell

et al. 2006

Journal of the American College of Cardiology

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“…Postoperative LOS has been adversely associated with neurological dysfunction in children with heart disease and a number of unfavorable outcomes in cardiac as well other group of patients [7]. Second, it can also allow for risk stratification, patient selection and efficient use of healthcare resources by decreasing the degree of variance in perioperative medical care and streamlining resource allocation [14].…”

Section: Commentmentioning

confidence: 99%

Preoperative Intubation and Lack of Enteral Nutrition are Associated with Prolonged Stay After Arterial Switch Operation

et al. 2016

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Mortality for the arterial switch operation (ASO) has diminished significantly over the past few decades. Some patients do, however, continue to have protracted and complicated courses after surgery. We attempted to determine which preoperative factors were best associated with prolonged hospital stay after ASO. We retrospectively reviewed all patients that underwent an ASO over a 10-year period. Outcomes of patients with postoperative stays (POS) >14 days (long stay group-LS) were compared with those patients with POS < 7 days (short stay group-SS). The following variables were evaluated: age at surgery, weight, septostomy performed (BAS) and management the day prior to surgery including use of prostaglandin E1 (PGE1), inotropes, intubation status and the establishment of enteral feeds. The SS group had 25 patients and the LS group had 32 patients. Both groups (SS vs. LS) were similar in PGE1 use (48 vs. 69 %), BAS (76 vs. 59 %), age at surgery (6 vs. 7 days) and preoperative inotropes (12 vs. 38 %). The SS group had significantly higher incidence of preoperative feeding (80 vs. 31 %, p < 0.001) and less frequent intubation (12 vs. 47 %, p < 0.001). Patients who are intubated and have not yet begun to receive enteral feeds at the time of their ASO are more likely to have prolonged POS. It is unclear if prolonged stays were a result of operating on patients with worse preoperative hemodynamics or a consequence of a preoperative management strategy that did not allow for extubation and establishment of feeds prior to surgery.

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Risk Factors for Higher Cost in Congenital Heart Operations

Cited by 37 publications

References 7 publications

Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals

Resource Use Among Adult Congenital Heart Surgery Admissions in Pediatric Hospitals

Surgical Versus Percutaneous Occlusion of Ostium Secundum Atrial Septal Defects

Preoperative Intubation and Lack of Enteral Nutrition are Associated with Prolonged Stay After Arterial Switch Operation

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