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Technical performance score is associated with outcomes after the Norwood procedure.

Publication ,  Journal Article
Nathan, M; Sleeper, LA; Ohye, RG; Frommelt, PC; Caldarone, CA; Tweddell, JS; Lu, M; Pearson, GD; Gaynor, JW; Pizarro, C; Williams, IA; Hill, K ...
Published in: J Thorac Cardiovasc Surg
November 2014

OBJECTIVES: The technical performance score (TPS) has been reported in a single center study to predict the outcomes after congenital cardiac surgery. We sought to determine the association of the TPS with outcomes in patients undergoing the Norwood procedure in the Single Ventricle Reconstruction trial. METHODS: We calculated the TPS (class 1, optimal; class 2, adequate; class 3, inadequate) according to the predischarge echocardiograms analyzed in a core laboratory and unplanned reinterventions that occurred before discharge from the Norwood hospitalization. Multivariable regression examined the association of the TPS with interval to first extubation, Norwood length of stay, death or transplantation, unplanned postdischarge reinterventions, and neurodevelopment at 14 months old. RESULTS: Of 549 patients undergoing a Norwood procedure, 356 (65%) had an echocardiogram adequate to assess atrial septal restriction or arch obstruction or an unplanned reintervention, enabling calculation of the TPS. On multivariable regression, adjusting for preoperative variables, a better TPS was an independent predictor of a shorter interval to first extubation (P=.019), better transplant-free survival before Norwood discharge (P<.001; odds ratio, 9.1 for inadequate vs optimal), shorter hospital length of stay (P<.001), fewer unplanned reinterventions between Norwood discharge and stage II (P=.004), and a higher Bayley II psychomotor development index at 14 months (P=.031). The TPS was not associated with transplant-free survival after Norwood discharge, unplanned reinterventions after stage II, or the Bayley II mental development index at 14 months. CONCLUSIONS: TPS is an independent predictor of important outcomes after Norwood and could serve as a tool for quality improvement.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

November 2014

Volume

148

Issue

5

Start / End Page

2208 / 2214.e6

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Reproducibility of Results
  • Reoperation
  • Quality Indicators, Health Care
  • Quality Improvement
  • Psychomotor Performance
 

Citation

APA
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Nathan, M., Sleeper, L. A., Ohye, R. G., Frommelt, P. C., Caldarone, C. A., Tweddell, J. S., … Pediatric Heart Network Investigators, . (2014). Technical performance score is associated with outcomes after the Norwood procedure. J Thorac Cardiovasc Surg, 148(5), 2208-2214.e6. https://doi.org/10.1016/j.jtcvs.2014.05.076
Nathan, Meena, Lynn A. Sleeper, Richard G. Ohye, Peter C. Frommelt, Christopher A. Caldarone, James S. Tweddell, Minmin Lu, et al. “Technical performance score is associated with outcomes after the Norwood procedure.J Thorac Cardiovasc Surg 148, no. 5 (November 2014): 2208-2214.e6. https://doi.org/10.1016/j.jtcvs.2014.05.076.
Nathan M, Sleeper LA, Ohye RG, Frommelt PC, Caldarone CA, Tweddell JS, et al. Technical performance score is associated with outcomes after the Norwood procedure. J Thorac Cardiovasc Surg. 2014 Nov;148(5):2208-2214.e6.
Nathan, Meena, et al. “Technical performance score is associated with outcomes after the Norwood procedure.J Thorac Cardiovasc Surg, vol. 148, no. 5, Nov. 2014, pp. 2208-2214.e6. Pubmed, doi:10.1016/j.jtcvs.2014.05.076.
Nathan M, Sleeper LA, Ohye RG, Frommelt PC, Caldarone CA, Tweddell JS, Lu M, Pearson GD, Gaynor JW, Pizarro C, Williams IA, Colan SD, Dunbar-Masterson C, Gruber PJ, Hill K, Hirsch-Romano J, Jacobs JP, Kaltman JR, Kumar SR, Morales D, Bradley SM, Kanter K, Newburger JW, Pediatric Heart Network Investigators. Technical performance score is associated with outcomes after the Norwood procedure. J Thorac Cardiovasc Surg. 2014 Nov;148(5):2208-2214.e6.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

November 2014

Volume

148

Issue

5

Start / End Page

2208 / 2214.e6

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Reproducibility of Results
  • Reoperation
  • Quality Indicators, Health Care
  • Quality Improvement
  • Psychomotor Performance