Abstract:
INTRODUCTION:Health care-associated infections (HAIs) increase mortality, length of stay, and cost in hospitalized patients. The incidence of and risk factors for developing HAIs in the pediatric population after cardiac surgery have been studied. This study evaluates the impact of HAIs on length of stay, inpatient mortality, and cost of hospitalization in the pediatric population after cardiac surgery. METHODS:The Kids' Inpatient Database was queried for analysis. Patients under 18 years of age who underwent cardiac surgery from 1997 to 2012 were included. HAIs were defined as central line-associated blood stream infections, catheter-associated urinary tract infections, ventilator-associated pneumonias, and surgical wound infections. Univariate analysis compared admissions with and without a HAI. Next, regression analysis was done to determine patient factors independently associated with a HAI, and to determine what specific HAIs were independently associated with our primary outcomes. RESULTS:In total 46 169 admissions were included, 773 (1.6%) of which had a HAI. Regression analysis showed younger age (P < .001), heart failure (OR 1.2, 95% CI 1.1-1.4, P = .03), and acute kidney injury (AKI; 2.7, 2.0-3.6, P < .001), among others were all independently associated with a HAI. The presence of HAI was associated with increased length of stay (median 29 vs 6 days, P < .001), total cost (median $271 884 vs $88 385, P < .001), and inpatient mortality (6.1% vs 2.5%, P < .001) by univariate analysis. Regression analysis demonstrated that each HAI were independently associated with increased length of stay and increased total charges for the hospital stay. However, HAI, was not associated with increased mortality after regression analysis. CONCLUSIONS:The incidence of HAIs in this analysis was low (1.6%) but contributed significantly to length of stay and cost. No individual HAI was associated with increased mortality. Potential modifiable risk factors include age and prevention of AKI.
journal_name
Congenit Heart Disjournal_title
Congenital heart diseaseauthors
Tweddell S,Loomba RS,Cooper DS,Benscoter ALdoi
10.1111/chd.12779subject
Has Abstractpub_date
2019-09-01 00:00:00pages
785-790issue
5eissn
1747-079Xissn
1747-0803journal_volume
14pub_type
杂志文章,多中心研究abstract:INTRODUCTION:Physician decisions drive most of the increases in health care expenditures, yet virtually no published literature has sought to understand the types of evidence used by physicians as they make decisions in real time. METHODS:Ten pediatric cardiologists recorded every clinically significant decision made ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2010.00433.x
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:Intraatrial Mustard baffle repair of dextro-transposition of the great arteries (d-TGA) is vulnerable to complications, typically obstruction and leaks. Because patients often require pacemakers or intracardiac electrophysiology studies (EPS)/ablation for arrhythmias, narrowed or obstructed baffles restrict c...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00532.x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Recent advances in various disciplines of medicine have significantly changed the courses following cardiac surgery in children. On-table extubation (OTE) after open heart surgery in children is evolving. OBJECTIVE:To assess the rate of postoperative complications in children extubated on table after open h...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12277
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:We aimed (1) determine if systemic right ventricle filling parameters influence systemic right ventricle stroke volume in adult patients with D-transposition of the great arteries (D-TGA) palliated by atrial switch, using cardiac magnetic resonance imaging and echocardiography, and (2) to study relationship ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12472
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Pectus excavatum is commonly viewed as a benign condition. Associated alterations in hemodynamics are rare. We present an unusual case of right ventricular inflow obstruction and hemodynamic compromise as a consequence of pectus excavatum encountered during surgical intervention. CASE:a 15-year-old male w...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2008.00231.x
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:Pulmonary autograft aortic root replacement (Ross' operation) is now associated with low operative risk. Recent series suggest that patients with primary aortic insufficiency have diminished autograft durability and that patients with large discrepancies between pulmonary and aortic valve sizes have a low but...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2008.00221.x
更新日期:2008-11-01 00:00:00
abstract::A male infant presented at birth with severe coarctation of the aorta and marginal left ventricular and mitral valve dimensions associated with a large secundum atrial septal defect. Following successful arch repair, the left ventricle remained small with preferential left-to-right atrial shunting and a dilated right ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2007.00140.x
更新日期:2007-11-01 00:00:00
abstract::Obesity is pandemic in Western society. Currently, approximately 100 million Americans are overweight (body mass index > 25 kg/m2) or obese (body mass index > 30 kg/m2). The pandemic is largely attributable to the relatively recent (from an evolutionary perspective) adoption of a sedentary lifestyle, coupled with the ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00618.x
更新日期:2012-03-01 00:00:00
abstract:PURPOSE:The aim of this article was to assess the role of MRI in the diagnosis and management of a variety of complex aortic arch anomalies. MATERIALS AND METHODS:Imaging was performed on a 1.5T Philips Gyroscan Intera. We retrospectively reviewed all cardiac MR scans performed from November 2003 to February 2007 at o...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2008.00174.x
更新日期:2008-03-01 00:00:00
abstract:INTRODUCTION:Cardiovascular diseases in pediatric pathologies have emerged in the recent years in sub-Saharan Africa (SSA), with congenital heart diseases (CHDs) being the most frequent. Unfortunately, their diagnosis is usually delayed, thereby increasing childhood morbidity and mortality. OBJECTIVES:Describe the cli...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12529
更新日期:2018-01-01 00:00:00
abstract::While right ventricle to pulmonary artery homograft is the surgical procedure of choice for relieving right ventricle outflow tract obstruction; it is limited by the need for multiple surgical replacements owing to progressive conduit obstruction, valve dysfunction, or patient growth. Since January 2010, percutaneous ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12013
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:The right ventricle (RV) supports the systemic circulation in patients who have had an intraatrial repair of transposition of the great arteries or have congenitally corrected transposition. There is concern about the ability of a systemic RV to support the additional volume load of pregnancy, and previous...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12001
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:Published case reports suggest that congenital portosystemic venous connections (PSVC) and other abdominal venous anomalies may be relatively frequent and potentially important in patients with polysplenia syndrome. Our objective was to investigate the frequency and range of portal and other abdominal systemi...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/j.1747-0803.2010.00478.x
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Improved weight gain during the interstage (IS) period has been shown to improve overall outcomes in patients with single ventricle physiology (SVP). This emphasis on nutrition may have untoward effects, such as increasing anxiety/stress levels in caregivers, who are already known to be at risk for increas...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12257
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:The electrocardiogram (ECG) is used to detect left ventricular hypertrophy (LVH) in children and young adults, and it is considered an important screening tool for the most common causes of sudden cardiac arrest in the United States. However, the reliability and accuracy of the ECG in the detection of LVH are...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12249
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:Clinical genetic testing is expanding rapidly, but the application of new testing has not been reported in an unselected, comprehensive congenital heart disease (CHD) patient population. This study aims to identify cytogenetic testing practices and diagnostic yield in infants with CHD as an important first st...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12112
更新日期:2014-03-01 00:00:00
abstract::We report a 51-year-old patient with platypnea-orthodeoxia syndrome after percutaneous closure of a secundum atrial septal defect, an unusual complication of this modality of treatment. Echocardiography, the main diagnostic technique in the present case, showed that one of the percutaneous device's rims was fixed to t...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2012.00639.x
更新日期:2012-09-01 00:00:00
abstract:UNLABELLED:BACKGROUND; Several studies have demonstrated the utility of B-type natriuretic peptide (BNP) in the months following cardiac transplant. The purpose of this study was to analyze longitudinal BNP data in pediatric cardiac transplant patients and determine the efficacy of BNP in routine follow-up of transplan...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2010.00417.x
更新日期:2010-05-01 00:00:00
abstract::Scimitar syndrome is characterized by anomalous pulmonary venous drainage of a part or the whole of the right lung into the inferior vena cava (IVC). It is extremely uncommon in scimitar syndrome for the pulmonary veins to drain anomalously to a site other than the IVC. The following case report describes an otherwise...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00513.x
更新日期:2012-01-01 00:00:00
abstract::Marfan syndrome is a well-described autosomal dominant syndrome with widely variable clinical manifestations. Cardiovascular complications include mitral valve prolapse with or without associated mitral valve insufficiency, aortic root dilatation, and most importantly the occasional development of aortic aneurysms or ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2006.00040.x
更新日期:2006-09-01 00:00:00
abstract:INTRODUCTION:Surveillance and management guidelines for Fontan patients are lacking due to the paucity of evidence in the literature of screening efficacy on outcome measures. METHODS:The Fontan Working Group within the New England Congenital Cardiology Association designed an electronic survey to assess surveillance ...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12854
更新日期:2019-11-01 00:00:00
abstract::So-called heterotaxy affects lateralization of the thoracic and abdominal organs. Congenital malformations may be present in one of several organ systems. Cardiac involvement includes both structural and conduction abnormalities. Data regarding arrhythmias in heterotaxy come from case reports and small case series. We...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/chd.12288
更新日期:2016-01-01 00:00:00
abstract::A 52-year-old male patient, with a medical history of surgically repaired double outlet right ventricle presented with severe aortic stenosis (AS) and hepatitis C with cirrhosis, presented with New York Heart Association Class IV heart failure. During evaluation for a liver transplant, he was deemed a poor surgical ca...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/chd.12114
更新日期:2014-09-01 00:00:00
abstract::Isolated left ventricular (LV) apical hypoplasia is a recently described congenital abnormality characterized by: (1) a truncated and spherical LV configuration with rightward bulging of the interventricular septum, (2) deficiency of the myocardium within the LV apex with adipose tissue infiltrating the apex, (3) orig...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00489.x
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Children and adolescents with congenital heart disease (CHD) and their families require qualified combined medical and psychosocial information, care, and counseling. This study aimed to analyze CHD patients' and parents' perception of disease-specific knowledge, state of health, and impairments experienced ...
journal_title:Congenital heart disease
pub_type: 杂志文章,多中心研究
doi:10.1111/chd.12581
更新日期:2018-05-01 00:00:00
abstract::Currently, the role of stress echocardiography primarily resides in diagnosing acquired coronary artery disease (CAD) in adults. Besides an increasing concern for traditional CAD in young patients due to obesity and other chronic pediatric diseases, there is also a growing population of adolescents and young adults wi...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/chd.12495
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:We previously identified a pathogenic germline DICER1 variant in a child with transposition of the great arteries who was a member of a family with DICER1 syndrome. In view of a report linking Dicer1 knockout in murine cardiomyocytes to cardiac outflow defects, we investigated the involvement of DICER1 in tra...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12578
更新日期:2018-05-01 00:00:00
abstract::In medical literature, few cases of Rasmussen's aneurysm have been reported until now, and to the best of our knowledge, there has been no description of a case of Rasmussen's aneurysm in childhood. The child described in the case report had a restrictive cardiomyopathy, complicated by pulmonary hypertension, in assoc...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00609.x
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:Nurse practitioners (NPs) have an established role for delivering competent care to patients in the primary care setting. The aim of this study was to compare satisfaction of patients managed by NPs vs. physicians in the outpatient adult congenital heart disease (CHD) clinic. DESIGN:A prospective study condu...
journal_title:Congenital heart disease
pub_type: 杂志文章,多中心研究
doi:10.1111/chd.12273
更新日期:2015-09-01 00:00:00
abstract::This is a case report reviewing the presentation and clinical course of a patient diagnosed with abdominal aortic atresia at the level caudal to the superior mesenteric artery. Patients with abdominal aortic atresia need to be evaluated for associated underlying syndromes or diseases. Although the prognosis for this d...
journal_title:Congenital heart disease
pub_type: 杂志文章,评审
doi:10.1111/j.1747-0803.2010.00454.x
更新日期:2011-05-01 00:00:00