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Impact of hospital volume on outcomes of percutaneous ASD/PFO closure in pediatric patients

摘要Background We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients. Methods We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002–2011. Patients with age ≤ 18 years and primary diagnosis code 745.5 for ASD were included. Hospital volume was calculated using unique identification numbers and divided into tertiles for analysis. Multivariate regression analysis was performed to determine independent predictors of procedure-related complications which were coded using specific codes released by Healthcare Cost and Utilization Project. Results 6162 percutaneous ASD closure procedures were analyzed. There was no mortality associated with percutaneous ASD closure. Cardiac complications (9.5%) were most common. On multivariate analysis, age increment of 3 years decreased the odds of developing complications (OR 0.83, 95% CI 0.79–0.87,P < 0.001). Odds of developing complications in the 2nd (OR 0.74, 95% CI 0.62–0.89,P = 0.007) and 3rd tertiles (OR 0.34, 95% CI 0.27–0.42,P < 0.001) were lower as compared to the 1st tertile of hospital volume. Conclusion Increasing annual hospital volume is an independent predictor of lower complication rates in percutaneous ASD closure cases with no associated mortality in pediatric patients.

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作者单位 Texas Tech University Health Sciences Center,Amarillo,TX,USA [1] University of Arkansas for Medical Sciences,Little Rock,AR,USA [2] Mt. Sinai St. Luke's Roosevelt Hospital Center,New York,NY,USA [3] Mercy Health,Cincinnati,OH,USA [4] Tulane University School of Public Health and Tropical Medicine,New Orleans,LA,USA [5] University of Washington,Seattle Children's Hospital,4800 Sand Point Way NE,Seattle,WA 98105,USA [6]
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发布时间 2018-11-28(万方平台首次上网日期,不代表论文的发表时间)
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世界儿科杂志(英文版)

世界儿科杂志(英文版)

2018年14卷4期

364-372页

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