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Factors Influencing Prolonged Hospital Stay in Surgically Treated Children and Adolescents with Left-to-Right Shunt Congenital Heart Disease: Evidence From a Hospital in Southern China

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Název: Factors Influencing Prolonged Hospital Stay in Surgically Treated Children and Adolescents with Left-to-Right Shunt Congenital Heart Disease: Evidence From a Hospital in Southern China
Autoři: Huang L, Zhang Y, Jiang S
Zdroj: Therapeutics and Clinical Risk Management, Vol 21, Iss Issue 1, Pp 1237-1247 (2025)
Informace o vydavateli: Dove Medical Press, 2025.
Rok vydání: 2025
Sbírka: LCC:Therapeutics. Pharmacology
Témata: Congenital heart disease, Left-to-right shunt, Surgical treatment, Prolonged hospital stay, Therapeutics. Pharmacology, RM1-950
Popis: Liudan Huang, Yuhua Zhang, Shaobo Jiang Department of Pediatrics, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of ChinaCorrespondence: Liudan Huang, Department of Pediatrics, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China, Email 15917932267@163.comBackground: Congenital heart disease(CHD) is a congenital malformation caused by abnormal development of the heart and large blood vessels, and left-to-right shunt CHD is a relatively common type. Surgical treatment has the problem of prolonged hospital stay in CHD patients. It is of great significance to explore the influencing factors of prolonged hospital stay after surgery therapy for children and adolescents with left-to-right shunt CHD.Methods: A total of 463 children and adolescents with left-to-right shunt CHD who received surgery therapy were retrospectively analyzed. Medical records (gender, CHD types, echocardiography, invasive mechanical ventilation, blood transfusion, tracheal intubation, intraoperative blood loss, and length of hospital stay) were collected. The threshold for prolonged hospital stay was defined based on the third quartile (75th percentile) of length of hospital stay in all patients. The relationship between clinical features and prolonged hospital stay was analyzed.Results: The mean length of hospital stay was 13.00 (7.00, 18.00) days, there were 330 (71.3%) patients with non-prolonged hospital stay (< 18.0 days) and 133 (28.7%) with prolonged stay (≥ 18.0 days). There were statistically significant differences in the distributions of types of CHD (χ2=67.959, p< 0.001), severity of mitral insufficiency (χ2=14.171, p=0.002) and pulmonary hypertension (χ2=49.611, p< 0.001), and the proportion of treated with invasive mechanical ventilation (χ2=104.657, p< 0.001), blood transfusion (χ2=117.649, p< 0.001), and tracheal intubation (χ2=67.752, p< 0.001) between CHD patients with prolonged and non-prolonged hospital stay. Multivariate logistic regression analysis showed that male (odds ratio(OR): 2.137, 95% confidence interval(CI): 1.278– 3.574, p=0.004), compound types CHD (OR: 2.021, 95% CI: 1.178– 3.469, p=0.011), pulmonary hypertension (OR: 3.179, 95% CI: 1.537– 6.572, p=0.002), invasive mechanical ventilation (OR: 4.069, 95% CI: 1.567– 10.564, p=0.004), and blood transfusion (OR: 5.128, 95% CI: 2.421– 10.862, p< 0.001) were independently associated with prolonged hospital stay.Conclusion: Male, compound types CHD, pulmonary hypertension, invasive mechanical ventilation, and blood transfusion were independently associated with prolonged hospital stay in CHD patients. It provides valuable information to guide the hospitalization management of CHD.Keywords: congenital heart disease, left-to-right shunt, surgical treatment, prolonged hospital stay
Druh dokumentu: article
Popis souboru: electronic resource
Jazyk: English
ISSN: 1178-203X
Relation: https://www.dovepress.com/factors-influencing-prolonged-hospital-stay-in-surgically-treated-chil-peer-reviewed-fulltext-article-TCRM; https://doaj.org/toc/1178-203X
Přístupová URL adresa: https://doaj.org/article/2ad55e32fbde45b3ab8c6bca95ec705b
Přístupové číslo: edsdoj.2ad55e32fbde45b3ab8c6bca95ec705b
Databáze: Directory of Open Access Journals
Popis
Abstrakt:Liudan Huang, Yuhua Zhang, Shaobo Jiang Department of Pediatrics, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of ChinaCorrespondence: Liudan Huang, Department of Pediatrics, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China, Email 15917932267@163.comBackground: Congenital heart disease(CHD) is a congenital malformation caused by abnormal development of the heart and large blood vessels, and left-to-right shunt CHD is a relatively common type. Surgical treatment has the problem of prolonged hospital stay in CHD patients. It is of great significance to explore the influencing factors of prolonged hospital stay after surgery therapy for children and adolescents with left-to-right shunt CHD.Methods: A total of 463 children and adolescents with left-to-right shunt CHD who received surgery therapy were retrospectively analyzed. Medical records (gender, CHD types, echocardiography, invasive mechanical ventilation, blood transfusion, tracheal intubation, intraoperative blood loss, and length of hospital stay) were collected. The threshold for prolonged hospital stay was defined based on the third quartile (75th percentile) of length of hospital stay in all patients. The relationship between clinical features and prolonged hospital stay was analyzed.Results: The mean length of hospital stay was 13.00 (7.00, 18.00) days, there were 330 (71.3%) patients with non-prolonged hospital stay (< 18.0 days) and 133 (28.7%) with prolonged stay (≥ 18.0 days). There were statistically significant differences in the distributions of types of CHD (χ2=67.959, p< 0.001), severity of mitral insufficiency (χ2=14.171, p=0.002) and pulmonary hypertension (χ2=49.611, p< 0.001), and the proportion of treated with invasive mechanical ventilation (χ2=104.657, p< 0.001), blood transfusion (χ2=117.649, p< 0.001), and tracheal intubation (χ2=67.752, p< 0.001) between CHD patients with prolonged and non-prolonged hospital stay. Multivariate logistic regression analysis showed that male (odds ratio(OR): 2.137, 95% confidence interval(CI): 1.278– 3.574, p=0.004), compound types CHD (OR: 2.021, 95% CI: 1.178– 3.469, p=0.011), pulmonary hypertension (OR: 3.179, 95% CI: 1.537– 6.572, p=0.002), invasive mechanical ventilation (OR: 4.069, 95% CI: 1.567– 10.564, p=0.004), and blood transfusion (OR: 5.128, 95% CI: 2.421– 10.862, p< 0.001) were independently associated with prolonged hospital stay.Conclusion: Male, compound types CHD, pulmonary hypertension, invasive mechanical ventilation, and blood transfusion were independently associated with prolonged hospital stay in CHD patients. It provides valuable information to guide the hospitalization management of CHD.Keywords: congenital heart disease, left-to-right shunt, surgical treatment, prolonged hospital stay
ISSN:1178203X