The Impact of Gestational Age on Resource Utilization After Open Heart Surgery for Congenital Cardiac Disease From Birth to 1 Year of Age

Abstract

The impact of gestational age on perioperative morbidity was examined using a novel construct, the resource utilization index (RUI). The medical records of subjects from birth to 1 year of age entered into a pediatric cardiothoracic surgery database from a major academic medical center between 2007 and 2011 were reviewed. The hypothesis tested was that infants born at 37-38 weeks (early-term infants) experience greater resource utilization after open heart surgery than those born at 39 completed weeks and that this association can be observed until 1 year of age. The results support the premise that resource utilization increases linearly with declining gestational age among infants at 0-12 months who undergo cardiac surgery. Five of the six variables comprising the RUI showed statistically significant linear associations with gestational age in the predicted direction. Multivariate linear regression analysis showed that gestational age was a significant predictor of an increased RUI composite. Further investigation is needed to test the concept and to expand on these findings.

Rehospitalization Following Neonatal Cardiac Surgery: Risk Factors and Outcomes

“…In a study by Bishop et al, a resource utilization index focused on the initial hospitalization was calculated using variables such as postoperative length of stay, time to initial extubation, pressors for greater than 24 hours, and mortality. 22 Among 179 infants < 1 year of age who underwent congenital heart surgery involving thoracotomy or cardiopulmonary bypass and were admitted to the Pediatric Intensive Care Unit postoperatively, the resource utilization index was found to increase linearly with decreasing gestational age. 22 Late deaths during readmissions were common in children with HLHS.…”

“…22 Among 179 infants < 1 year of age who underwent congenital heart surgery involving thoracotomy or cardiopulmonary bypass and were admitted to the Pediatric Intensive Care Unit postoperatively, the resource utilization index was found to increase linearly with decreasing gestational age. 22 Late deaths during readmissions were common in children with HLHS. Late mortality in HLHS has been previously reported to be 10 to 67%.…”

Resource use in neonatal cardiac surgery: Lacking details

“…1 Factors associated with increased resource use in neonatal cardiac surgery include gestational age, intrauterine growth restriction, and extracardiac comorbid conditions. 2,3 Further, admission to a dedicated cardiac intensive care unit (CICU) was found to be associated with decreased resource use in a single-institution study. 4 Johnson and colleagues, 5 the same group that conducted that earlier study, 4 report in this edition of the Journal a confirmation of their initial findings with a multicenter study of data from the Pediatric Hospital Information Systems (PHIS) database.…”