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Emergency department utilisation and critical readmission in patients with Fontan circulation.

Publication ,  Journal Article
Cashen, K; Petersen, TL; Rood, C; Cater, D; Waslawski, SF; Slaven, JE; Mastropietro, CW
Published in: Cardiol Young
December 2020

BACKGROUND: We aimed to conduct a multi-centre study characterising emergency department utilisation and critical readmissions experienced by children with Fontan circulation. METHODS: We conducted a retrospective review of children who underwent the Fontan operation at three institutions (i.e., centres A, B, and C) between 2009 and 2014, with follow-up through December 2015. Multi-variable analyses were performed to determine factors associated for emergency department utilisation within 1 year of surgery, emergency department utilisation at any time following surgery, or critical readmission (defined as admission to ICU, operating room, or cardiac catheterisation). RESULTS: We reviewed 297 patients, of which 147 patients (49%) had 607 emergency department encounters. Forty-six patients (15%) required 71 critical readmissions. Multi-variable analyses revealed centre C (p = 0.02) and post-operative hospitalisation ≥ 14 days (p = 0.03) to be significantly associated with emergency department utilisation within 1 year, whereas centre B (p < 0.001), post-operative hospitalisation ≥ 14 days (p = 0.002), and African-American/Black race (p = 0.04) were significantly associated with critical readmission. CONCLUSIONS: In this multi-centre study, nearly half of patients with Fontan circulation received emergency department care, often presenting with high disease acuity requiring readmission. Emergency department utilisation and need for critical readmission were independently influenced by the centre at which surgery was performed, prolonged post-operative hospitalisation, and racial background. These data could help guide quality improvement efforts aimed at reducing morbidity in this unique patient population.

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Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

December 2020

Volume

30

Issue

12

Start / End Page

1902 / 1909

Location

England

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Patient Readmission
  • Humans
  • Hospitalization
  • Fontan Procedure
  • Emergency Service, Hospital
  • Child
  • Cardiovascular System & Hematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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Cashen, K., Petersen, T. L., Rood, C., Cater, D., Waslawski, S. F., Slaven, J. E., & Mastropietro, C. W. (2020). Emergency department utilisation and critical readmission in patients with Fontan circulation. Cardiol Young, 30(12), 1902–1909. https://doi.org/10.1017/S1047951120003121
Cashen, Katherine, Tara L. Petersen, Cailyn Rood, Daniel Cater, Sheila F. Waslawski, James E. Slaven, and Christopher W. Mastropietro. “Emergency department utilisation and critical readmission in patients with Fontan circulation.Cardiol Young 30, no. 12 (December 2020): 1902–9. https://doi.org/10.1017/S1047951120003121.
Cashen K, Petersen TL, Rood C, Cater D, Waslawski SF, Slaven JE, et al. Emergency department utilisation and critical readmission in patients with Fontan circulation. Cardiol Young. 2020 Dec;30(12):1902–9.
Cashen, Katherine, et al. “Emergency department utilisation and critical readmission in patients with Fontan circulation.Cardiol Young, vol. 30, no. 12, Dec. 2020, pp. 1902–09. Pubmed, doi:10.1017/S1047951120003121.
Cashen K, Petersen TL, Rood C, Cater D, Waslawski SF, Slaven JE, Mastropietro CW. Emergency department utilisation and critical readmission in patients with Fontan circulation. Cardiol Young. 2020 Dec;30(12):1902–1909.
Journal cover image

Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

December 2020

Volume

30

Issue

12

Start / End Page

1902 / 1909

Location

England

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Patient Readmission
  • Humans
  • Hospitalization
  • Fontan Procedure
  • Emergency Service, Hospital
  • Child
  • Cardiovascular System & Hematology
  • 1102 Cardiorespiratory Medicine and Haematology