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Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.

Publication ,  Journal Article
Hornik, CP; He, X; Jacobs, JP; Li, JS; Jaquiss, RDB; Jacobs, ML; O'Brien, SM; Peterson, ED; Pasquali, SK
Published in: Ann Thorac Surg
November 2011

BACKGROUND: Limited multicenter data exist regarding the prevalence of postoperative complications after the Norwood operation and their associated mortality risk. METHODS: We evaluated infants in The Society of Thoracic Surgeons Congenital Heart Surgery Database who underwent the Norwood operation from 2000 to 2009. The prevalence of postoperative complications after the Norwood operation and associated in-hospital mortality were described. Patient factors associated with complications were evaluated in multivariable analyses. RESULTS: A total of 2,557 patients from 53 centers were included. Median age at operation was 6 days (interquartile range, 4 to 9 days) and 90% had a right dominant ventricle. Overall mortality was 22%, and 75% had 1 complication or more. Mortality increased with increasing number of complications: 1 complication, 17%; 2 complications, 21%; 3 complications, 26%; 4 complications, 33%; and 5 or more complications, 45%. Renal and cardiovascular complications carried the greatest mortality risk. Patient factors associated with 1 complication or more included weight less than 2.5 kg (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.2 to 2.1), single right versus single left ventricle (OR, 1.4; 95% CI, 1.01 to 2.0), preoperative shock (OR, 1.5; 95% CI, 1.1 to 2.1), non-cardiac/genetic abnormality (OR, 1.5; 95% CI, 1.2 to 1.9), and preoperative mechanical ventilatory (OR, 1.3; 95% CI, 1.03 to 1.6) or circulatory (OR 4.0; 95%CI, 1.6 to 10.2) support. CONCLUSIONS: Complications after the Norwood operation are common, carry significant mortality risk, and are associated with several preoperative patient characteristics. These data may aid in providing prognostic information to families and in guiding quality improvement initiatives.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

November 2011

Volume

92

Issue

5

Start / End Page

1734 / 1740

Location

Netherlands

Related Subject Headings

  • Respiratory System
  • Prevalence
  • Postoperative Complications
  • Norwood Procedures
  • Male
  • Infant, Newborn
  • Humans
  • Female
  • Databases, Factual
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Hornik, C. P., He, X., Jacobs, J. P., Li, J. S., Jaquiss, R. D. B., Jacobs, M. L., … Pasquali, S. K. (2011). Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg, 92(5), 1734–1740. https://doi.org/10.1016/j.athoracsur.2011.05.100
Hornik, Christoph P., Xia He, Jeffrey P. Jacobs, Jennifer S. Li, Robert D. B. Jaquiss, Marshall L. Jacobs, Sean M. O’Brien, Eric D. Peterson, and Sara K. Pasquali. “Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.Ann Thorac Surg 92, no. 5 (November 2011): 1734–40. https://doi.org/10.1016/j.athoracsur.2011.05.100.
Hornik CP, He X, Jacobs JP, Li JS, Jaquiss RDB, Jacobs ML, et al. Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2011 Nov;92(5):1734–40.
Hornik, Christoph P., et al. “Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database.Ann Thorac Surg, vol. 92, no. 5, Nov. 2011, pp. 1734–40. Pubmed, doi:10.1016/j.athoracsur.2011.05.100.
Hornik CP, He X, Jacobs JP, Li JS, Jaquiss RDB, Jacobs ML, O’Brien SM, Peterson ED, Pasquali SK. Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2011 Nov;92(5):1734–1740.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

November 2011

Volume

92

Issue

5

Start / End Page

1734 / 1740

Location

Netherlands

Related Subject Headings

  • Respiratory System
  • Prevalence
  • Postoperative Complications
  • Norwood Procedures
  • Male
  • Infant, Newborn
  • Humans
  • Female
  • Databases, Factual
  • 3202 Clinical sciences