Related Experiment Videos
[Prognostic study of single ventricle with respect of anatomical and clinical data]
G Trémeau1, A Bozio, F Chapuis
1Service de cardiologie C, Hôpital cardiovasculaire et pneumologique, BP Lyon-Monchat.
Insights
Prognostic factors for single ventricle heart defects were analyzed in 185 pediatric patients. Key negative survival predictors include low admission pH, non-left ventricular morphology, aortic outflow obstruction, and total anomalous pulmonary venous drainage.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Medical Statistics
Context:
- Single ventricle (SV) is a complex congenital heart defect requiring specialized care.
- Understanding prognostic factors is crucial for managing patients with SV.
- This study retrospectively analyzed a significant cohort of SV patients.
Purpose:
- To identify anatomical and clinical factors influencing survival in patients with single ventricle.
- To establish a multivariable model for predicting patient outcomes.
Summary:
- A retrospective analysis of 185 patients with single ventricle was conducted.
- Kaplan-Meier and logrank tests identified potential survival predictors.
- Multivariable logistic regression revealed four independent negative prognostic factors: pH < 7.3 (OR=3.55), non-left ventricular morphology (OR=3.11), aortic outflow obstruction (OR=5.58), and total anomalous pulmonary venous drainage (OR=26.88).
Impact:
- Identifies critical variables for risk stratification in single ventricle patients.
- Informs clinical decision-making and prognostic counseling.
- Highlights specific anatomical and physiological challenges impacting survival.
Abstract:
The authors analysed the anatomical and clinical prognostic factors of single or common ventricle. This retrospective study was based on a series of 185 patients hospitalised between 1/2/70 and 31/12/91 in the paediatric cardiological unit of the Cardiological Hospital of Lyon with this condition. A number of anatomical and clinical parameters were identified in this population. For each parameter, a given patient could only relate to single modality and a survival graph determined by Kaplan-Meier analysis was established for each modality. For each variable, the survival curve of the most frequently encountered modality served as a reference and the other modalities were compared with it using a logrank test. The different modalities potentially related to patient survival were then entered into a multivariable model using logistic regression. The results of this study of multivariable analysis using the Odds-Ratio (OR) independently suggest that four variables may influence negatively survival of patients with a single ventricle: pH < or = 7.3 on admission (OR = 3.55), a non-left ventricular morphology of the main ventricular chamber (OR = 3.11), the presence of an obstacle on the aortic outflow (OR = 5.58) and a total anomalous pulmonary venous drainage (OR = 26.88).