Down syndrome and postoperative complications after paediatric cardiac surgery: A propensity-matched analysis

Roland Tóth, Péter Szántó, Zsolt Prodán, Daniel J. Lex, Erzsébet Sápi, A. Szatmári, J. Gál, Tamás Szántó, Andrea Székely

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

OBJECTIVESThe incidence of congenital heart disease is ∼50%, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery.METHODSOur perioperative data were analysed in paediatric patients with Down syndrome undergoing cardiac surgery. We retrospectively analysed the data from 2063 consecutive paediatric patients between January 2003 and December 2008. After excluding the patients who died or had missing data, the analysed database (before propensity matching) contained 129 Down patients and 1667 non-Down patients. After propensity matching, the study population comprised 222 patients and 111 patients had Down syndrome.RESULTSBefore propensity matching, the occurrences of low output syndrome (21.2 vs 32.6%, P = 0.003), pulmonary complication (14 vs 28.7%, P <0.001) and severe infection (11.9 vs 22.5%, P = 0.001) were higher in the Down group. Down patients were more likely to have prolonged mechanical ventilation [median (interquartile range) 22 (9-72) h vs 49 (24-117) h, P = 0.007]. The total intensive care unit length of stay [6.9 (4.2-12.4) days vs 8.3 (5.3-13.2) days, P = 0.04] and the total hospital length of stay [17.3 (13.3-23.2) days vs 18.3 (15.1-23.6) days, P = 0.05] of the Down patients were also longer. Mortality was similar in the two groups before (3.58 vs 3.88%, P = 0.86) and after (5.4 vs 4.5%, P = 1.00) propensity matching. After propensity matching, there was no difference in the occurrence of adverse events.CONCLUSIONSAfter propensity matching Down syndrome was not associated with increased mortality or complication rate following congenital cardiac surgery.

Original languageEnglish
Pages (from-to)691-697
Number of pages7
JournalInteractive Cardiovascular and Thoracic Surgery
Volume17
Issue number4
DOIs
Publication statusPublished - Oct 2013

Fingerprint

Down Syndrome
Thoracic Surgery
Pediatrics
Length of Stay
Endocardial Cushion Defects
Mortality
Artificial Respiration
Intensive Care Units
Heart Diseases
Databases
Lung
Incidence
Infection

Keywords

  • Congenital heart disease
  • Down syndrome
  • Paediatric cardiac surgery
  • Paediatrics
  • Predictors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Down syndrome and postoperative complications after paediatric cardiac surgery : A propensity-matched analysis. / Tóth, Roland; Szántó, Péter; Prodán, Zsolt; Lex, Daniel J.; Sápi, Erzsébet; Szatmári, A.; Gál, J.; Szántó, Tamás; Székely, Andrea.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 17, No. 4, 10.2013, p. 691-697.

Research output: Contribution to journalArticle

Tóth, Roland ; Szántó, Péter ; Prodán, Zsolt ; Lex, Daniel J. ; Sápi, Erzsébet ; Szatmári, A. ; Gál, J. ; Szántó, Tamás ; Székely, Andrea. / Down syndrome and postoperative complications after paediatric cardiac surgery : A propensity-matched analysis. In: Interactive Cardiovascular and Thoracic Surgery. 2013 ; Vol. 17, No. 4. pp. 691-697.
@article{76f6a6f4cd5e42f788f888c1119fbc6a,
title = "Down syndrome and postoperative complications after paediatric cardiac surgery: A propensity-matched analysis",
abstract = "OBJECTIVESThe incidence of congenital heart disease is ∼50{\%}, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery.METHODSOur perioperative data were analysed in paediatric patients with Down syndrome undergoing cardiac surgery. We retrospectively analysed the data from 2063 consecutive paediatric patients between January 2003 and December 2008. After excluding the patients who died or had missing data, the analysed database (before propensity matching) contained 129 Down patients and 1667 non-Down patients. After propensity matching, the study population comprised 222 patients and 111 patients had Down syndrome.RESULTSBefore propensity matching, the occurrences of low output syndrome (21.2 vs 32.6{\%}, P = 0.003), pulmonary complication (14 vs 28.7{\%}, P <0.001) and severe infection (11.9 vs 22.5{\%}, P = 0.001) were higher in the Down group. Down patients were more likely to have prolonged mechanical ventilation [median (interquartile range) 22 (9-72) h vs 49 (24-117) h, P = 0.007]. The total intensive care unit length of stay [6.9 (4.2-12.4) days vs 8.3 (5.3-13.2) days, P = 0.04] and the total hospital length of stay [17.3 (13.3-23.2) days vs 18.3 (15.1-23.6) days, P = 0.05] of the Down patients were also longer. Mortality was similar in the two groups before (3.58 vs 3.88{\%}, P = 0.86) and after (5.4 vs 4.5{\%}, P = 1.00) propensity matching. After propensity matching, there was no difference in the occurrence of adverse events.CONCLUSIONSAfter propensity matching Down syndrome was not associated with increased mortality or complication rate following congenital cardiac surgery.",
keywords = "Congenital heart disease, Down syndrome, Paediatric cardiac surgery, Paediatrics, Predictors",
author = "Roland T{\'o}th and P{\'e}ter Sz{\'a}nt{\'o} and Zsolt Prod{\'a}n and Lex, {Daniel J.} and Erzs{\'e}bet S{\'a}pi and A. Szatm{\'a}ri and J. G{\'a}l and Tam{\'a}s Sz{\'a}nt{\'o} and Andrea Sz{\'e}kely",
year = "2013",
month = "10",
doi = "10.1093/icvts/ivt267",
language = "English",
volume = "17",
pages = "691--697",
journal = "Interactive Cardiovascular and Thoracic Surgery",
issn = "1569-9293",
publisher = "European Association for Cardio-Thoracic Surgery",
number = "4",

}

TY - JOUR

T1 - Down syndrome and postoperative complications after paediatric cardiac surgery

T2 - A propensity-matched analysis

AU - Tóth, Roland

AU - Szántó, Péter

AU - Prodán, Zsolt

AU - Lex, Daniel J.

AU - Sápi, Erzsébet

AU - Szatmári, A.

AU - Gál, J.

AU - Szántó, Tamás

AU - Székely, Andrea

PY - 2013/10

Y1 - 2013/10

N2 - OBJECTIVESThe incidence of congenital heart disease is ∼50%, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery.METHODSOur perioperative data were analysed in paediatric patients with Down syndrome undergoing cardiac surgery. We retrospectively analysed the data from 2063 consecutive paediatric patients between January 2003 and December 2008. After excluding the patients who died or had missing data, the analysed database (before propensity matching) contained 129 Down patients and 1667 non-Down patients. After propensity matching, the study population comprised 222 patients and 111 patients had Down syndrome.RESULTSBefore propensity matching, the occurrences of low output syndrome (21.2 vs 32.6%, P = 0.003), pulmonary complication (14 vs 28.7%, P <0.001) and severe infection (11.9 vs 22.5%, P = 0.001) were higher in the Down group. Down patients were more likely to have prolonged mechanical ventilation [median (interquartile range) 22 (9-72) h vs 49 (24-117) h, P = 0.007]. The total intensive care unit length of stay [6.9 (4.2-12.4) days vs 8.3 (5.3-13.2) days, P = 0.04] and the total hospital length of stay [17.3 (13.3-23.2) days vs 18.3 (15.1-23.6) days, P = 0.05] of the Down patients were also longer. Mortality was similar in the two groups before (3.58 vs 3.88%, P = 0.86) and after (5.4 vs 4.5%, P = 1.00) propensity matching. After propensity matching, there was no difference in the occurrence of adverse events.CONCLUSIONSAfter propensity matching Down syndrome was not associated with increased mortality or complication rate following congenital cardiac surgery.

AB - OBJECTIVESThe incidence of congenital heart disease is ∼50%, mostly related to endocardial cushion defects. The aim of our study was to investigate the postoperative complications that occur after paediatric cardiac surgery.METHODSOur perioperative data were analysed in paediatric patients with Down syndrome undergoing cardiac surgery. We retrospectively analysed the data from 2063 consecutive paediatric patients between January 2003 and December 2008. After excluding the patients who died or had missing data, the analysed database (before propensity matching) contained 129 Down patients and 1667 non-Down patients. After propensity matching, the study population comprised 222 patients and 111 patients had Down syndrome.RESULTSBefore propensity matching, the occurrences of low output syndrome (21.2 vs 32.6%, P = 0.003), pulmonary complication (14 vs 28.7%, P <0.001) and severe infection (11.9 vs 22.5%, P = 0.001) were higher in the Down group. Down patients were more likely to have prolonged mechanical ventilation [median (interquartile range) 22 (9-72) h vs 49 (24-117) h, P = 0.007]. The total intensive care unit length of stay [6.9 (4.2-12.4) days vs 8.3 (5.3-13.2) days, P = 0.04] and the total hospital length of stay [17.3 (13.3-23.2) days vs 18.3 (15.1-23.6) days, P = 0.05] of the Down patients were also longer. Mortality was similar in the two groups before (3.58 vs 3.88%, P = 0.86) and after (5.4 vs 4.5%, P = 1.00) propensity matching. After propensity matching, there was no difference in the occurrence of adverse events.CONCLUSIONSAfter propensity matching Down syndrome was not associated with increased mortality or complication rate following congenital cardiac surgery.

KW - Congenital heart disease

KW - Down syndrome

KW - Paediatric cardiac surgery

KW - Paediatrics

KW - Predictors

UR - http://www.scopus.com/inward/record.url?scp=84885010324&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885010324&partnerID=8YFLogxK

U2 - 10.1093/icvts/ivt267

DO - 10.1093/icvts/ivt267

M3 - Article

C2 - 23832837

AN - SCOPUS:84885010324

VL - 17

SP - 691

EP - 697

JO - Interactive Cardiovascular and Thoracic Surgery

JF - Interactive Cardiovascular and Thoracic Surgery

SN - 1569-9293

IS - 4

ER -