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. 2017 Jun:185:88-93.e3.
doi: 10.1016/j.jpeds.2017.02.011. Epub 2017 Mar 3.

Mortality and Morbidity after Laparoscopic Surgery in Children with and without Congenital Heart Disease

David I Chu  1 , Jonathan M Tan  2 , Peter Mattei  3 , Andrew T Costarino  4 , Joseph W Rossano  5 , Gregory E Tasian  6
Affiliations

Mortality and Morbidity after Laparoscopic Surgery in Children with and without Congenital Heart Disease

David I Chu et al. J Pediatr. 2017 Jun.

Abstract

Objectives: To determine the risk of morbidity and mortality after laparoscopic surgery among children with congenital heart disease (CHD).

Study design: Cohort study using the 2013-2014 National Surgical Quality Improvement Program-Pediatrics, which prospectively collected data at 56 and 64 hospitals in 2013 and 2014, respectively. Primary exposure was CHD. Primary outcome was overall in-hospital postoperative mortality. Secondary outcomes included 30-day mortality and 30-day morbidity (any nondeath adverse event). Among 34?543 children who underwent laparoscopic surgery, 1349, 1106, and 266 had minor, major, and severe CHD, respectively. After propensity score matching within each stratum of CHD severity, morbidity and mortality were compared between children with and without CHD.

Results: Children with severe CHD had higher overall mortality and 30-day morbidity (OR 12.31, 95% CI 1.59-95.01; OR 2.51, 95% CI 1.57-4.01, respectively), compared with matched controls. Overall mortality and 30-day morbidity were also higher among children with major CHD compared with children without CHD (OR 3.46, 95% CI 1.49-8.06; OR 2.07, 95% CI 1.65-2.61, respectively). Children with minor CHD had similar mortality outcomes, but had higher 30-day morbidity compared with children without CHD (OR 1.71, 95% CI 1.37-2.13).

Conclusions: Children with major or severe CHD have higher morbidity and mortality after laparoscopic surgery. Clinicians should consider the increased risks of laparoscopic surgery for these children during medical decision making.

Keywords: NSQIP; laparoscopy; minimally invasive surgery; outcomes; pediatric.

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Conflict of interest statement

Financial disclosure: The authors have no financial relationship relevant to this article to disclose.

The authors declare no conflicts of interest.

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References

    1. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–900. - PubMed
    1. Gilboa SM, Devine OJ, Kucik JE, Oster ME, Riehle-Colarusso T, Nembhard WN, et al. Congenital Heart Defects in the United States: Estimating the Magnitude of the Affected Population in 2010. Circulation. 2016;134:101–9. - PMC - PubMed
    1. Sulkowski JP, Cooper JN, McConnell PI, Pasquali SK, Shah SS, Minneci PC, et al. Variability in noncardiac surgical procedures in children with congenital heart disease. J Pediatr Surg. 2014;49:1564–9. - PMC - PubMed
    1. Faraoni D, Zurakowski D, Vo D, Goobie SM, Yuki K, Brown ML, et al. Post-Operative Outcomes in Children With and Without Congenital Heart Disease Undergoing Noncardiac Surgery. J Am Coll Cardiol. 2016;67:793–801. - PubMed
    1. Firilas AM, Jackson RJ, Smith SD. Minimally invasive surgery: the pediatric surgery experience. J Am Coll Surg. 1998;186:542–4. - PubMed

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