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Prescription medication use after congenital heart surgery

Published online by Cambridge University Press:  06 January 2022

Alireza Raissadati Open the ORCID record for Alireza Raissadati [Opens in a new window] ,
Jari Haukka ,
Tommi Pätilä ,
Heta Nieminen  and
Eero Jokinen
Alireza Raissadati*
Affiliation:
Department of Surgery and Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children’s Hospital, Palo Alto, California, USA
Jari Haukka
Affiliation:
Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland Department of Health Sciences, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
Tommi Pätilä
Affiliation:
Department of Surgery and Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
Heta Nieminen
Affiliation:
Department of Surgery and Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
Eero Jokinen
Affiliation:
Department of Surgery and Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
*
Author for correspondence: Alireza Raissadati, New Children’s Hospital, Stenbäckinkatu 9, Building 6, 00290 Helsinki, PO Box 281, Finland. Tel: +1 781-975-6250. E-mail: [email protected]
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Abstract

Background:

Improvements in mortality after congenital heart surgery have necessitated a shift in focus to postoperative morbidity as an outcome measure. We examined late morbidity after congenital heart surgery based on prescription medication use.

Methods:

Between 1953 and 2009, 10,635 patients underwent congenital heart surgery at <15 years of age in Finland. We obtained 4 age-, sex-, birth-time, and hospital district-matched controls per patient. The Social Insurance Institution of Finland provided data on all prescription medications obtained between 1999 and 2012 by patients and controls. Patients were assigned one diagnosis based on a hierarchical list of cardiac defects and dichotomised into simple and severe groups. Medications were divided into short- and long-term based on indication. Follow-up started at the first operation and ended at death, emigration, or 31 December, 2012.

Results:

Totally, 8623 patients met inclusion criteria. Follow-up was 99.9%. In total, 8126 (94%) patients required prescription medications. Systemic anti-bacterials were the most common short-term prescriptions among patients (93%) and controls (88%). Patients required betablockers (simple hazard ratio 1.9, 95% confidence interval 1.7–2.1; severe hazard ratio 6.5, 95% confidence interval 5.3–8.1) and diuretics (simple hazard ratio 3.2, 95% CI 2.8–3.7; severe hazard ratio 38.8, 95% CI 27.5–54.7) more often than the general population. Both simple and severe defects required medication for cardiovascular, gastrointestinal, psychiatric, neurologic, metabolic, autoimmune, and infectious diseases more often than the general population.

Conclusions:

The significant risk for postoperative cardiovascular and non-cardiovascular disease warrants close long-term follow-up after congenital heart surgery for all defects.

Keywords

CHDoutcomemorbidityepidemiologypaediatric cardiology
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 11 , November 2022 , pp. 1786 - 1793
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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