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Patent ductus arteriosus ligation: are we doing better?
W M Novick1, D C Watson, B S Alpert
1Department of Pediatric Cardiology, LeBonheur Children's Medical Center, University of Tennessee, Memphis.
The Annals of Thoracic Surgery
|April 1, 1995
Summary
Surgical outcomes for patent ductus arteriosus ligation in children over 3 months old improved significantly after 1991. Perioperative length of stay and hospital charges decreased without increased morbidity.
Area of Science:
- Pediatric Surgery
- Health Economics
Background:
- Healthcare resource limitations necessitate re-evaluation of preoperative standards.
- Patent ductus arteriosus (PDA) ligation is a common pediatric surgical procedure.
Purpose of the Study:
- To assess changes in perioperative care efficiency and cost for PDA ligation in children older than 3 months.
- To determine if efficiency improvements impacted patient outcomes.
Main Methods:
- Retrospective review of clinical and financial records for children undergoing PDA ligation (July 1984 - April 1994).
- Patients with isolated PDA, >3 months old, and no complications were stratified into two groups based on operation date (pre- vs. post-January 1, 1991).
- Analysis of age, length of stay, readmissions, and adjusted hospital charges.
Main Results:
- A significant reduction in perioperative length of stay was observed in Group II (2.7 days) compared to Group I (3.9 days) (p < 0.0001).
- Hospital charges were significantly lower in Group II ($6,600) versus Group I ($8,700) (p < 0.0001).
- No increase in postdischarge morbidity was noted.
Conclusions:
- Elective patent ductus arteriosus ligation in children over 3 months has become more efficient and cost-effective.
- Improved perioperative care standards have been implemented without compromising patient safety or increasing complications.
- These findings support evidence-based adjustments to surgical care protocols in response to healthcare policy.