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The impact of medical interventions on admission characteristics in children with congenital heart disease and cardiomyopathy

Published online by Cambridge University Press:  16 December 2020

Rohit S. Loomba Open the ORCID record for Rohit S. Loomba [Opens in a new window] ,
Jacqueline Rausa ,
Vincent Dorsey ,
Ronald A. Bronicki ,
Enrique G. Villarreal Open the ORCID record for Enrique G. Villarreal [Opens in a new window]  and
Saul Flores Open the ORCID record for Saul Flores [Opens in a new window]
Rohit S. Loomba
Affiliation:
Division of Cardiology, Advocate Children’s Hospital, Chicago, IL, USA Department of Pediatrics, Chicago Medical School/Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
Jacqueline Rausa
Affiliation:
Division of Cardiology, Advocate Children’s Hospital, Chicago, IL, USA
Vincent Dorsey
Affiliation:
Division of Cardiology, Advocate Children’s Hospital, Chicago, IL, USA
Ronald A. Bronicki
Affiliation:
Section of Critical Care Medicine and Cardiology, Texas Children’s Hospital, Houston, TX, USA Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
Enrique G. Villarreal*
Affiliation:
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
Saul Flores
Affiliation:
Section of Critical Care Medicine and Cardiology, Texas Children’s Hospital, Houston, TX, USA Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
*
Author for correspondence: E. G. Villarreal, MD, Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico. Tel: +(811) 324-4817. E-mail: [email protected]
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Abstract

Introduction:

Children with congenital heart disease and cardiomyopathy are a unique patient population. Different therapies continue to be introduced with large practice variability and questionable outcomes. The purpose of this study is to determine the impact of various medications on intensive care unit length of stay, total length of stay, billed charges, and mortality for admissions with congenital heart disease and cardiomyopathy.

Materials and methods:

We identified admissions of paediatric patients with cardiomyopathy using the Pediatric Health Information System database. The admissions were then separated into two groups: those with and without inpatient mortality. Univariate analyses were conducted between the groups and the significant variables were entered as independent variables into the regression analyses.

Results:

A total of 10,376 admissions were included these analyses. Of these, 904 (8.7%) experienced mortality. Comparing patients who experienced mortality with those who did not, there was increased rate of acute kidney injury with an odds ratio (OR) of 5.0 [95% confidence interval (CI) 4.3 to 5.8, p < 0.01], cardiac arrest with an OR 7.5 (95% CI 6.3 to 9.0, p < 0.01), and heart transplant with an OR 0.3 (95% CI 0.2 to 0.4, p < 0.01). The medical interventions with benefit for all endpoints after multivariate regression analyses in this cohort are methylprednisolone, captopril, enalapril, furosemide, and amlodipine.

Conclusions:

Diuretics, steroids, angiotensin-converting enzyme inhibitors, calcium channel blockers, and beta blockers all appear to offer beneficial effects in paediatric cardiomyopathy admission outcomes. Specific agents within each group have varying effects.

Keywords

cardiomyopathycongenital heart defectmortality ratepaediatricshospital cost
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 3 , March 2021 , pp. 406 - 413
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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