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Technical performance score is associated with outcomes after the Norwood procedure
Meena Nathan1, Lynn A Sleeper2, Richard G Ohye3
1Children's Hospital Boston and Harvard Medical School, Boston, Mass.
The Journal of Thoracic and Cardiovascular Surgery
|July 20, 2014
Summary
The Technical Performance Score (TPS) predicts outcomes in Norwood procedure patients, indicating shorter extubation times, better survival, and improved neurodevelopment. This score can guide quality improvement efforts in congenital cardiac surgery.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Surgical Outcomes Research
Background:
- The Technical Performance Score (TPS) has shown promise in predicting outcomes after congenital cardiac surgery.
- Its utility in the context of the Norwood procedure, a critical intervention for single-ventricle physiology, requires further investigation.
Purpose of the Study:
- To evaluate the association between the Technical Performance Score (TPS) and patient outcomes in the Norwood procedure.
- To determine if TPS can serve as a quality improvement tool in this specific surgical context.
Main Methods:
- The Technical Performance Score (TPS) was calculated based on predischarge echocardiograms and unplanned reinterventions before discharge.
- Multivariable regression analysis was employed to assess the relationship between TPS and key outcomes, including extubation time, length of stay, survival, reinterventions, and neurodevelopment.
Main Results:
- A better TPS was independently associated with a shorter interval to first extubation (P=.019).
- Higher TPS predicted better transplant-free survival before Norwood discharge (P<.001) and shorter hospital length of stay (P<.001).
- Improved TPS correlated with fewer unplanned reinterventions and better psychomotor development at 14 months (P=.031).
Conclusions:
- The Technical Performance Score (TPS) is an independent predictor of significant outcomes following the Norwood procedure.
- TPS demonstrates potential as a valuable tool for quality improvement initiatives in congenital cardiac surgery.
