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Association of Previous Cardiac Surgery With Postoperative Pneumonia in Infants Undergoing Abdominal Operations: A Cohort Study.
Zlotolow, Morgan; Mpody, Christian; Carrillo, Sergio A; Elmitwalli, Islam; Nazir, Wajahat; Nafiu, Olubukola O; Tobias, Joseph D.
Afiliación
  • Zlotolow M; Department of Pediatrics, Nationwide Children's Hospital and the Ohio State University College of Medicine, Columbus, OH, USA.
  • Mpody C; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA; Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.
  • Carrillo SA; Department of Pediatric Cardiothoracic Surgery, Nationwide Children's Hospital and the Ohio State University College of Medicine, Columbus, OH, USA.
  • Elmitwalli I; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
  • Nazir W; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
  • Nafiu OO; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA; Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.
  • Tobias JD; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA; Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA. Electronic address: Joseph.Tobias@Nationwidechildrens.org.
J Pediatr Surg ; : 161676, 2024 Aug 14.
Article en En | MEDLINE | ID: mdl-39244419
ABSTRACT

BACKGROUND:

Children with congenital heart disease (CHD) often require other, non-cardiac related surgical procedures following their initial cardiac surgery. After full or partial CHD repair, they remain at increased risk of postoperative complications. We examined the association of previous cardiac intervention (surgery or percutaneous catheterization intervention) with postoperative pneumonia in infants undergoing abdominal general surgery.

METHODS:

A 11 propensity score-matched study was conducted using a retrospective cohort of 104,820 infants (<12 months) who had general abdominal surgeries between 2012 and 2022 in U.S. hospitals participating in the National Surgical Quality Improvement Program. The primary outcome was postoperative pneumonia within 30 days. Secondary outcomes included unplanned reintubation, prolonged mechanical ventilation (>72 h), and extended hospital stay (>75th percentile for the study cohort).

RESULTS:

Of the study cohort, 9736 infants (9.3%) had previous cardiac interventions. In the propensity score-matched sample, infants with previous cardiac surgery had increased risks of postoperative pneumonia (1.3% vs 0.8%; adjusted relative risk [RRadj] 1.64, 95% CI 1.22, 2.18, p = 0.001), unplanned reintubation (57.8% vs 32.6%; RRadj 1.77, 95% CI 1.77, 1.85, p < 0.001), prolonged mechanical ventilation (5.0% vs 2.3%; RRadj 2.14, 95% CI 1.83, 2.52, p < 0.001), and prolonged hospital stays (61.0% vs 53.8%; RRadj 1.13, 95% CI 1.10, 1.17, p < 0.001).

CONCLUSIONS:

A history of previous cardiac intervention carries an increased risk of postoperative pneumonia, unplanned tracheal reintubation, prolonged mechanical ventilation, as well as longer hospital stays following intra-abdominal surgery. Clinicians should closely monitor these patients for respiratory complications after surgery. LEVEL OF EVIDENCE II.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pediatr Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pediatr Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos