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Noncardiac surgical procedures common in children with CHD

ORLANDO, Fla. — Noncardiac surgical procedures are often performed in children with critical congenital heart disease, according to abstract findings presented here.

“While several studies have examined hospital-level variability and patient-outcomes in children receiving surgery for correction or palliation of [congenital heart disease], few studies have focused on variability and outcomes after noncardiac surgical procedures performed in children with [congenital heart disease],” the researchers wrote. “The purpose of this study was to examine the volume and variability of noncardiac surgeries performed in patients with critical [congenital heart disease].”

The multicenter cohort study included 8,857 patients with congenital heart disease (CHD) who underwent congenital heart surgery by age 1 year with a 5-year minimum follow-up.

Of included patients, 15.6% had a major noncardiac structure anomaly and 10% had a major genetic anomaly. Forty-one percent of patients had 13,894 noncardiac surgical procedures at age 5 years. More than half of the noncardiac surgical procedures were general (31.9%) or otolaryngology (28.8%).

Patients in higher Risk Adjustment for Congenital Heart Surgery (RACHS-1) categories were more likely to have general (OR=1.88); dental (OR=1.84); orthopedic (OR=2.35); plastic (OR=1.76); thoracic (OR=3.50), and urologic (OR=1.51) procedures compared with patients in the lower RACHS-1 group. However, they were less likely to have otolaryngologic (OR=0.70) and ophthalmologic (OR=0.41) procedures compared with the lower RACHS-1 group.

 

Samir Shah

”Children with CHD frequently receive surgery for noncardiac conditions,” Samir Shah, MD, MSCE, of Cincinnati Children’s Hospital Medical Center, told Infectious Diseases in Children. “We found that two of every five infants who received congenital heart surgery also received a surgical procedure for a noncardiac condition, most often general surgical or ear, nose, and throat procedures. There was also substantial variation in the frequency at which these procedures were performed at different hospitals. Our study suggests that we need a better understanding of all the conditions affecting infants with CHD to better define indications for and risks of additional surgical procedures.”

For more information:

Sulkowski JP. Abstract #21201. Presented at: AAP National Conference and Exhibition; Oct. 26-29, 2013; Orlando, Fla.

Disclosure: The researchers report no relevant financial disclosures.