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Predictors of Post-Operative Hospital Length of Stay Following Complete Repair of Tetralogy of Fallot in a Pediatric Cohort in the North of England

Lookup NU author(s): Adenike AdesanyaORCiD, Dr Louise Coats, Professor Judith Rankin

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2023, The Author(s).We sought to estimate the median post-operative length of stay (PLOS) and predictors of PLOS following tetralogy of Fallot (ToF) repair at a specialist surgical center in the North of England. The local National Congenital Heart Disease Audit dataset was used to identify patients aged < 2 years who underwent surgical repair for ToF between 1 January 1986 and 13 May 2022. Coefficients representing the median change in PLOS (days) according to predictors were estimated using Quantile regression. There were 224 patients (59.4% male, median age = 9 months, interquartile range (IQR) 5–13 months) with a median PLOS of 9 days (IQR 7–13). In the univariable regression, age (months) and weight (kg) at operation (β = − 0.17, 95% CI: − 0.33, − 0.01) and (β = − 0.53, 95% CI: − 0.97, − 0.10), previous (cardiac or thoracic) procedure (β = 5, 95% CI:2.38, 7.62), procedure urgency (elective vs urgent) (β = 2.8, 95% CI:0.39, 5.21), bypass time (mins) (β = 0.03, 95% CI:0.01, 0.05), cross-clamp time (mins) (β = 0.03, 95% CI:0.01, 0.06) and duration of post-operative intubation (days) (β = 0.81, 95% CI:0.67, 0.96), were significantly associated with PLOS. Previous procedure and intubation time remained significant in multivariable analyses. Some patient and operative factors can predict PLOS following complete ToF repair. Information on PLOS is important for health professionals to support parents in preparing for their child's discharge and to make any necessary practical arrangements. Health commissioners can draw on evidence-based guidance for resource planning. The small sample size may have reduced the power to detect small effect sizes, but this regional study serves as a foundation for a larger national study.


Publication metadata

Author(s): Adesanya AM, Best KE, Coats L, Rankin J

Publication type: Article

Publication status: Published

Journal: Pediatric Cardiology

Year: 2024

Volume: 45

Pages: 92-99

Online publication date: 12/09/2023

Acceptance date: 25/08/2023

Date deposited: 28/09/2023

ISSN (print): 0172-0643

ISSN (electronic): 1432-1971

Publisher: Springer

URL: https://doi.org/10.1007/s00246-023-03287-7

DOI: 10.1007/s00246-023-03287-7

PubMed id: 37698700


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Funding

Funder referenceFunder name
BH181803Newcastle upon Tyne Hospitals NHS Charity
National Institute for Health and Care Research (NIHR)
Newcastle Upon Tyne Hospitals NHS Charity
NIHR200173

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