Related Experiment Video
Updated: Oct 25, 2025
Author Spotlight: Establishment and Confirmation of a Postnatal Right Ventricular Volume Overload Mouse Model
Published on: June 9, 2023
Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants
Doaa M Aly1, Lori A Erickson1, Hayley Hancock1
1Ward Family Heart Center Children's Mercy Hospital Kansas City MO.
Insights
We developed a home video telemetry (HVT) score to predict unplanned hospital admissions in infants with single ventricle heart conditions. This objective tool aids early detection of clinical deterioration, improving infant care during the critical interstage period.
Area of Science:
- Pediatric Cardiology
- Medical Technology
- Clinical Monitoring
Background:
- The Cardiac High Acuity Monitoring Program (CHAMP) utilizes home video telemetry (HVT) for monitoring infants with single ventricle post-surgery.
- The interstage period presents a high risk for clinical deterioration and unplanned hospital admissions (UHA) in these infants.
Purpose of the Study:
- To develop an objective early warning score using HVT data.
- To identify infants with single ventricle at high risk for clinical deterioration and UHA.
Main Methods:
- Six candidate parameters from HVT were selected to create a pragmatic scoring system.
- Binary logistic regression and ROC curves analyzed the predictive ability of parameters for UHA.
- Comparison of pre-admission HVT videos with baseline videos from infants with single ventricle.
Main Results:
- The final HVT score model, incorporating respiratory rate, effort, color, and behavior, showed excellent discriminatory capability (AUC 93%).
- A score of 5 demonstrated high specificity (93.8%) and sensitivity (88.7%) for predicting UHA.
- The scoring system was feasible for routine evaluation, with high observation completion rates.
Conclusions:
- A feasible and reproducible HVT score was developed to predict UHA in infants with single ventricle.
- This HVT score can serve as a valuable tool for early identification of at-risk infants.
- Prospective, multicenter validation is recommended for this novel monitoring tool.
Abstract:
Background Our Cardiac High Acuity Monitoring Program (CHAMP) uses home video telemetry (HVT) as an adjunct to monitor infants with single ventricle during the interstage period. This study describes the development of an objective early warning score using HVT, for identification of infants with single ventricle at risk for clinical deterioration and unplanned hospital admissions (UHA). Methods and Results Six candidate scoring parameters were selected to develop a pragmatic score for routine evaluation of HVT during the interstage period. We evaluated the individual and combined ability of these parameters to predict UHA. All infants with single ventricle monitored at home by CHAMP between March 2014 and March 2018 were included. Videos obtained within 48 hours before UHA were compared with videos obtained at baseline. We used binary logistic regression models and receiver operating characteristic curves to evaluate the parameters' performance in discriminating the outcome of interest. Thirty-nine subjects with 64 UHA were included. We compared 64 pre-admission videos to 64 paired baseline videos. Scoring was feasible for a mean of 91.6% (83.6%-98%) of all observations. Three different HVT score models were proposed, and a final model composed of respiratory rate, respiratory effort, color, and behavior exhibited an excellent discriminatory capability with an area under the receiver operating characteristic curve of 93% (89%-98%). HVT score of 5 was associated with specificity of 93.8% and sensitivity of 88.7% in predicting UHA. Conclusions We developed a feasible and reproducible HVT score that can serve as a tool to predict UHA in infants with single ventricle. Future directions involve prospective, multicenter validation of this tool.
