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A composite outcome for neonatal cardiac surgery research
Ryan J Butts1, Mark A Scheurer1, Sinai C Zyblewski1
1Division of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
The Journal of Thoracic and Cardiovascular Surgery
|April 17, 2013
Summary
A new composite outcome for neonatal cardiac surgery, including signs of poor cardiac output, is linked to longer hospital stays and higher costs. This outcome may be a valuable endpoint for future clinical trials in neonates.
Area of Science:
- Cardiology
- Neonatal Surgery
- Clinical Trials
Background:
- Neonatal cardiac surgery presents unique challenges in outcome assessment.
- Objective signs of inadequate cardiac output are critical indicators of patient status.
Purpose of the Study:
- To evaluate a composite outcome measure for neonates undergoing cardiac surgery.
- To determine if this composite outcome correlates with other key clinical and financial metrics.
Main Methods:
- Prospective enrollment of 76 neonates undergoing cardiopulmonary bypass.
- Defined composite outcome: death, mechanical support, cardiac arrest, hepatic/renal injury, or lactic acidosis.
- Assessed associations with ventilation duration, ICU/hospital stay, and hospital charges.
Main Results:
- 39% of neonates met the composite outcome.
- Meeting the composite outcome significantly correlated with longer mechanical ventilation, ICU and hospital stays, and increased hospital charges.
- These associations remained significant after controlling for surgical complexity.
Conclusions:
- The developed composite outcome is strongly associated with adverse early operative results in neonates.
- This composite outcome shows promise as a relevant endpoint for clinical research in neonatal cardiac surgery.
