Andreea Alina Andronache, Roberta Di Cosola, Martina Evangelista, Sara Boveri, Laura Schianchi, Alessandro Giamberti, Massimo Chessa
{"title":"晚期诺伍德手术后的院内和阶段间死亡率:在时间紧迫的情况下认识风险。","authors":"Andreea Alina Andronache, Roberta Di Cosola, Martina Evangelista, Sara Boveri, Laura Schianchi, Alessandro Giamberti, Massimo Chessa","doi":"10.3390/children11101262","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A Norwood procedure performed after 14 days of life is notably burdened by a high mortality. We analysed the real risk and which other factors influence the mortality in late Norwood procedures.</p><p><strong>Methods: </strong>A single-centre, retrospective review of a series of consecutive patients who underwent a surgical Norwood procedure from January 2019 until December 2023. The patients' characteristics were considered to identify the factors associated with in-hospital and interstage mortality.</p><p><strong>Results: </strong>35 patients were included and 71% (25) of the patients underwent the Norwood procedure after 14 days of life. The median age was 27 days (6-259 days). The in-hospital mortality was 26% (9/35) with 89% (8) of the deceased being older than 15 days at the time of the surgery. Other factors that negatively affected the outcome were a restrictive interatrial septum defect (ASD) in 66% of all patients (23), the need for mechanical ventilation in 46% (16) and systemic infection prior to surgery in 43% (15).</p><p><strong>Conclusions: </strong>Age at the time of Norwood was not associated with a higher risk of mortality, but other factors such as restrictive ASD, preoperative infection and the need for mechanical ventilation prior to surgery are even more important in predicting the short-term outcome.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506364/pdf/","citationCount":"0","resultStr":"{\"title\":\"In-Hospital and Interstage Mortality After Late Norwood Procedure: Acknowledging the Risks When We Are Running Out of Time.\",\"authors\":\"Andreea Alina Andronache, Roberta Di Cosola, Martina Evangelista, Sara Boveri, Laura Schianchi, Alessandro Giamberti, Massimo Chessa\",\"doi\":\"10.3390/children11101262\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A Norwood procedure performed after 14 days of life is notably burdened by a high mortality. We analysed the real risk and which other factors influence the mortality in late Norwood procedures.</p><p><strong>Methods: </strong>A single-centre, retrospective review of a series of consecutive patients who underwent a surgical Norwood procedure from January 2019 until December 2023. The patients' characteristics were considered to identify the factors associated with in-hospital and interstage mortality.</p><p><strong>Results: </strong>35 patients were included and 71% (25) of the patients underwent the Norwood procedure after 14 days of life. The median age was 27 days (6-259 days). The in-hospital mortality was 26% (9/35) with 89% (8) of the deceased being older than 15 days at the time of the surgery. Other factors that negatively affected the outcome were a restrictive interatrial septum defect (ASD) in 66% of all patients (23), the need for mechanical ventilation in 46% (16) and systemic infection prior to surgery in 43% (15).</p><p><strong>Conclusions: </strong>Age at the time of Norwood was not associated with a higher risk of mortality, but other factors such as restrictive ASD, preoperative infection and the need for mechanical ventilation prior to surgery are even more important in predicting the short-term outcome.</p>\",\"PeriodicalId\":48588,\"journal\":{\"name\":\"Children-Basel\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506364/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Children-Basel\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/children11101262\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Children-Basel","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/children11101262","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
In-Hospital and Interstage Mortality After Late Norwood Procedure: Acknowledging the Risks When We Are Running Out of Time.
Background: A Norwood procedure performed after 14 days of life is notably burdened by a high mortality. We analysed the real risk and which other factors influence the mortality in late Norwood procedures.
Methods: A single-centre, retrospective review of a series of consecutive patients who underwent a surgical Norwood procedure from January 2019 until December 2023. The patients' characteristics were considered to identify the factors associated with in-hospital and interstage mortality.
Results: 35 patients were included and 71% (25) of the patients underwent the Norwood procedure after 14 days of life. The median age was 27 days (6-259 days). The in-hospital mortality was 26% (9/35) with 89% (8) of the deceased being older than 15 days at the time of the surgery. Other factors that negatively affected the outcome were a restrictive interatrial septum defect (ASD) in 66% of all patients (23), the need for mechanical ventilation in 46% (16) and systemic infection prior to surgery in 43% (15).
Conclusions: Age at the time of Norwood was not associated with a higher risk of mortality, but other factors such as restrictive ASD, preoperative infection and the need for mechanical ventilation prior to surgery are even more important in predicting the short-term outcome.
期刊介绍:
Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries.
The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.