Related Experiment Video
Updated: Oct 18, 2025
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Early Functional Status After Surgery for Congenital Heart Disease: A Single-Center Retrospective Study
Brian Han1, Jeffrey K Yang2, Albee Y Ling3
1Department of Pediatrics, Division of Cardiology, Lucile Packard Children's Hospital Stanford, Stanford University Medical Center, Palo Alto, CA.
Insights
This study assessed functional status changes in pediatric patients after congenital heart surgery using the Functional Status Scale (FSS). While overall FSS changes were small, new morbidity occurred in 4.6% and unfavorable outcomes in 1%, linked to surgical factors and longer hospital stays.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery Outcomes
- Functional Status Assessment
Background:
- Congenital heart surgery significantly impacts pediatric patients' functional status.
- The Functional Status Scale (FSS) is a tool to measure functional changes.
- Assessing functional status post-surgery is crucial for recovery and long-term outcomes.
Purpose of the Study:
- To investigate changes in functional status in pediatric patients undergoing congenital heart surgery.
- To apply the Functional Status Scale (FSS) in this specific patient population.
- To identify risk factors associated with new morbidity and unfavorable functional outcomes.
Main Methods:
- A retrospective study of 1,398 pediatric patients (0-18 years) undergoing congenital heart surgery.
- Utilized the Functional Status Scale (FSS) to assess changes from admission to discharge.
- Modified Poisson regression analyzed associations between risk factors and outcomes like new morbidity (FSS change ≥ 3) and unfavorable outcomes (FSS change ≥ 5).
Main Results:
- New morbidity (FSS change ≥ 3) occurred in 4.6% of patients; unfavorable outcomes (FSS change ≥ 5) in 1.0%.
- Higher Society of Thoracic Surgeons (STS) score, single-ventricle physiology, and longer cardiopulmonary bypass times were associated with new morbidity.
- Longer hospital length of stay correlated with both new morbidity and unfavorable functional outcomes.
Conclusions:
- The Functional Status Scale (FSS) can be applied to pediatric congenital heart surgery patients.
- While overall FSS scores showed minimal change, specific adverse outcomes occurred.
- Risk factors like STS score, single-ventricle physiology, bypass time, and hospital stay duration influence functional outcomes, warranting further investigation.
Objectives:
The objective of this study is to investigate the change in functional status in infants, children, and adolescents undergoing congenital heart surgery using the Functional Status Scale.
Design:
A single-center retrospective study.
Setting:
A 26-bed cardiac ICU in a free-standing university-affiliated tertiary children's hospital.
Patients:
All patients 0-18 years who underwent congenital heart surgery from January 1, 2014, to December 31, 2017.
Interventions:
None.
Measurements And Min Results:
The primary outcome variable was change in Functional Status Scale scores from admission to discharge. Additionally, two binary outcomes were derived from the primary outcome: new morbidity (change in Functional Status Scale ≥ 3) and unfavorable functional outcome (change in Functional Status Scale ≥ 5); their association with risk factors was assessed using modified Poisson regression. Out of 1,398 eligible surgical encounters, 65 (4.6%) and 15 (1.0%) had evidence of new morbidity and unfavorable functional outcomes, respectively. Higher Surgeons Society of Thoracic and the European Association for Cardio-Thoracic Surgery score, single-ventricle physiology, and longer cardiopulmonary bypass time were associated with new morbidity. Longer hospital length of stay was associated with both new morbidity and unfavorable outcome.
Conclusions:
This study demonstrates the novel application of the Functional Status Scale on patients undergoing congenital heart surgery. New morbidity was noted in 4.6%, whereas unfavorable outcome in 1%. There was a small change in the total Functional Status Scale score that was largely attributed to changes in the feeding domain. Higher Society of Thoracic and the European Association for Cardio-Thoracic Surgery score, single-ventricle physiology, and longer cardiopulmonary bypass times were associated with new morbidity, whereas longer hospital length of stay was associated with both new morbidity and unfavorable outcome. Further studies with larger sample size will need to be done to confirm our findings and to better ascertain the utility of Functional Status Scale on this patient population.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:30Heart Failure IV: Classification and Diagnostic Evaluation