Pediatric Cardiology最新文献

{"title":"Neighborhood Income Disparities in Unplanned Hospital Admission and In-Hospital Outcomes Among Children with Congenital Heart Disease.","authors":"Laxmi V Ghimire, Sagya Khanal, Zareh Torabyan, Hiba El-Rahi, Catherine Cong, Fu-Sheng Chou, Othman A Aljohani, Anita J Moon-Grady","doi":"10.1007/s00246-024-03755-8","DOIUrl":"https://doi.org/10.1007/s00246-024-03755-8","url":null,"abstract":"<p><p>Unplanned admissions are associated with worse clinical outcomes and increased hospital resource utilization. We hypothesized that children with congenital heart disease (CHD) from lower-income neighborhoods have higher rates of unplanned hospital admissions and greater resource utilization. Utilizing the Kids' Inpatient Database (2016 and 2019), we included children under 21 years of age with CHD, excluding newborn hospitalizations. CHD cases were categorized into simple lesions, complex biventricular lesions, and single ventricle lesions. Admissions were classified as surgical or non-surgical. A logistic regression model assessed the risk of unplanned hospital admission, mortality, and resource utilization across different neighborhood income levels. Out of 4,722,684 admitted children (excluding newborn hospitalizations), 199,757 had CHD and met the study criteria: 121,626 with mild CHD, 61,639 with complex biventricular lesions, and 16,462 with single ventricle lesions. Surgical admissions comprised 20% (n = 39,694). In the CHD cohort, 27% had planned admissions, while 73% were unplanned. Mortality was higher in unplanned admissions compared to planned admissions (3.0 vs. 0.93%, P < 0.001). Unplanned admissions were more common in the lowest-income neighborhoods compared to the highest-income neighborhoods (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.3-1.5; P < 0.001), consistent across different age groups. Higher rates of unplanned admissions in the lowest-income neighborhoods were observed for each CHD category and for both medical and surgical admissions. Median hospitalization length was longer in the poorest neighborhoods compared to the wealthiest (7 days [IQR 3-21] vs. 6 days [IQR 3-17], P < 0.001). In conclusion, children with CHD residing in the lowest-income neighborhoods have increased odds of unplanned hospitalization for both surgical and non-surgical admissions, along with higher mortality and resource utilization.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"Risk Factors and Outcomes Associated with Gaps in Care in Children with Congenital Heart Disease\".","authors":"Disha Bai, Sonia Kumari, Kanwal Majeed","doi":"10.1007/s00246-024-03758-5","DOIUrl":"https://doi.org/10.1007/s00246-024-03758-5","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"Comparison of Risk Scoring Systems in Predicting Kawasaki Disease Associated Coronary Artery Dilation in a North American Cohort\".","authors":"F N U Ridham, Insiya Fatima Azad, Muskan Kumari, Kanwal Majeed","doi":"10.1007/s00246-024-03754-9","DOIUrl":"https://doi.org/10.1007/s00246-024-03754-9","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Perceptions of Developmental Care Rounds in a Pediatric Heart Center.","authors":"Chetna K Pande, Joseph Burns, Sarah Schwab, Michelle Medchill, Claire Rizk, Robin Schlosser, Kelly Davis, Sofia Carretero, Danielle Kimbrough, Justin Elhoff","doi":"10.1007/s00246-024-03741-0","DOIUrl":"https://doi.org/10.1007/s00246-024-03741-0","url":null,"abstract":"<p><p>Infants requiring surgery for congenital heart disease (CHD) are at an increased risk of neurodevelopmental delay. Developmental Care Rounds (DCR) have been implemented widely to support the neurodevelopment of children with CHD while admitted to the hospital. This study aims to describe caregiver perceptions of DCR at a quaternary academic children's heart center. Over 17 months, caregivers were asked to evaluate DCR by responding to Likert scale statements by level of agreement as well as free-form text responses. The Likert scales were analyzed and free-form responses were manually reviewed to identify key themes. Forty-nine families participated in the assessment. One hundred percent of caregivers reported that they \"Agree\" or \"Strongly Agree,\" to the surveyed questions. These included queries regarding the benefit and utility of DCR. In the qualitative assessment, responses identified themes surrounding feeling more empowered to be active members of the care team, an increased awareness of the importance of regular developmental care during hospitalization, as well as education regarding available resources to promote appropriate developmental care. Some of the specific tools parents reported learning include reading, speaking aloud to children, limiting screen time, and engaging in skin-to-skin contact. This is one of the first descriptions of caregiver perceptions of DCR in pediatric patients with CHD. Our results indicate parental satisfaction with DCR and the identification of specific tools to aid in their children's development. DCR may offer an opportunity to improve neurodevelopmental outcomes in hospitalized children with CHD, which should be a focus of future study.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Coronary Artery Evaluation Using Noncontrast-Enhanced Magnetic Resonance Angiography in Patients with Kawasaki Disease.","authors":"Haruki Nonaka, Masahiro Tahara, Takayuki Yoshiura, Kotaro Urayama, Mio Okano, Yuko Morikawa, Risa Morita, Tomoyasu Sato","doi":"10.1007/s00246-024-03742-z","DOIUrl":"https://doi.org/10.1007/s00246-024-03742-z","url":null,"abstract":"<p><p>To evaluate the use of noncontrast-enhanced coronary magnetic resonance angiography (NC-CMRA) for long-term follow-up in patients with Kawasaki disease (KD). In total, 40 (77 aneurysms) patients with KD who underwent NC-CMRA were retrospectively analyzed. Coronary artery aneurysms and dilations observed during the acute phase were classified into three groups according to their diameter based on the American Heart Association criteria. The prevalence of coronary artery stenotic lesions was evaluated using the Kaplan-Meier method (log-rank test). The agreement in the coronary artery stenosis rates between NC-CMRA and coronary angiography (CAG) was examined via Brand-Altman analysis and intraclass correlation coefficients (ICC). In patients with large or giant aneurysms, the prevalence of coronary artery stenotic lesions was 26.3% at 10 years, 53.2% at 15 years, and 71.9% at 20 years. In patients with medium aneurysms, the prevalence of coronary artery stenotic lesions was 8.4% at 10 and 15 years and 23.7% at 20 years. Patients with small aneurysms did not exhibit stenotic lesions. Patients with large or giant aneurysms had significantly higher rate of coronary stenotic lesions than those with medium and small aneurysms (p < 0.05). All 16 stenotic lesions detected on NC-CMRA were consistent with those observed on CAG, and the coronary artery stenotic rate had moderate consistency (ICC 0.65). In KD, the detection of coronary artery stenosis using NC-CMRA was consistent with that using CAG. Therefore, NC-CMRA can be a better alternative following echocardiography for long-term coronary artery evaluation in patients with KD.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment Regarding \"The Influence of Arrhythmia on the Outcomes of Pediatric Patients with Idiopathic Dilated Cardiomyopathy\".","authors":"Mirna Hussein","doi":"10.1007/s00246-024-03756-7","DOIUrl":"https://doi.org/10.1007/s00246-024-03756-7","url":null,"abstract":"<p><p>The article \"The Influence of Arrhythmia on the Outcomes of Pediatric Patients with Idiopathic Dilated Cardiomyopathy\" by Mohammad Dalili et al. provides valuable insights into the impact of arrhythmia on idiopathic dilated cardiomyopathy outcomes. However, it presents with certain limitations. The study does not consider the link between arrhythmia outcomes and key confounding factors, which can potentially impact the outcome at hand. Moreover, the follow-up interval of year potentially limits the understanding of the longer term implications of arrhythmia in pediatric idiopathic dilated cardiomyopathy. Future research should consider the interplay between these confounding factors and arrhythmias associated with dilated cardiomyopathy, and implement longer follow-up intervals.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of CRISP Modifiers for Adults Undergoing Cardiac Catheterization Procedures: A Single Center Experience.","authors":"Kathryn P Reynolds, Ernesto Mejia, Natalie Soszyn, Gareth Morgan, Jenny E Zablah","doi":"10.1007/s00246-024-03728-x","DOIUrl":"https://doi.org/10.1007/s00246-024-03728-x","url":null,"abstract":"<p><p>The Catheterization RISk Score for Pediatrics (CRISP) has been validated and widely adopted as a model to predict adverse outcomes. We sought to determine if the addition of three modifiers (NYHA Class > 2, prior sternotomies > 2, and BMI > 30) to the CRISP score would better predict adverse events (AE) in adults undergoing cardiac catheterization at our institution. All adults (> 18 years) who underwent cardiac catheterization at the Children's Hospital Colorado from November 2016 to November 2021 were included. Baseline and modified CRISP scores with adult modifiers and AEs were analyzed. Of a total of 401 cases, there were 27 AEs (6.7%). A higher CRISP score was associated with an increased risk of AEs (p = 0.004). A ROC analysis of the CRISP score gave a AUC of 66% with a cut-off point of 5.5 giving a sensitivity of 74% and specificity of 52%. The modifiers individually did not significantly correlate with AEs. Higher modified CRISP score was similarly associated with an increased risk of AEs (p = 0.01). ROC analysis for the modified CRISP score gave an AUC of 64%. A cut-off point of 6.5 gave the best result with a sensitivity of 59% and specificity of 61%. A modified CRISP score which included adult modifiers similarly predicts AEs in adults with congenital heart disease. These adult modifiers are easy to incorporate into the CRISP score. The CRISP score also predicted AEs in adults with congenital heart disease.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"Congenital Heart Defects in Patients with Anorectal Malformations: A Retrospective Cohort Study of 281 Patients\".","authors":"F N U Ridham, Muskan Kumari, Kanwal Majeed, Insiya Fatima","doi":"10.1007/s00246-024-03740-1","DOIUrl":"https://doi.org/10.1007/s00246-024-03740-1","url":null,"abstract":"","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albuminuria Prevalence in Fontan Patients: A Systematic Review and Meta-Analysis.","authors":"Hannah Van Belle, Jef Van den Eynde, Aleksandra Cieplucha, Magalie Ladouceur, Kimberly Martinod, Sophie Pierard, Louise Coats, Katrijn Jansen, Alexander Opotowsky, Amaryllis H Van Craenenbroeck, Werner Budts, Alexander Van De Bruaene","doi":"10.1007/s00246-024-03736-x","DOIUrl":"https://doi.org/10.1007/s00246-024-03736-x","url":null,"abstract":"<p><p>Patients with a Fontan circulation are at risk for chronic kidney disease (CKD), which is defined as persistently reduced glomerular filtration rate (GFR) <60ml/min/1.73² or elevated marker of kidney injury such as urinary albumin-to-creatinine ratio (UACR) >30mg/g. We determined the prevalence of albuminuria in patients with a Fontan circulation. The MEDLINE, EMBASE, Trip, and Cochrane databases were searched for studies reporting the prevalence of albuminuria in Fontan patients. Case reports, reviews, and univentricular patients pre-Fontan completion or post-heart transplantation were excluded. Studies were assessed for potential confounders and measurement, patient selection, intervention, and reporting biases, reported in a table. After systematic review, the pooled prevalence of albuminuria was calculated using the quality effects model for meta-analysis. Secondary outcomes were the clinical determinants of albuminuria. Thirteen studies were included in the systematic review, of which 11 were included in the meta-analysis (6 prospective, sample size per study 25-195 patients, 873 patients in total). The pooled prevalence of albuminuria was 28.4% (95% confidence interval 23.5-33.5%). GFR was mostly preserved in these patients. Albuminuria was associated with elevated systemic venous pressure in 5 studies. Other associations were inconclusive. The main limitations of our study are the predominantly retrospective and cross-sectional nature of the included studies with small sample sizes and heterogeneous study populations. Our findings show albuminuria is more prevalent than reduced GFR in patients with a Fontan circulation, implicating the potential value of UACR in addition to GFR when screening for CKD in these patients.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PDA Stenting for Ductal-Dependent Cyanotic Congenital Heart Disease: History and View from 10,000 Feet.","authors":"John W Moore","doi":"10.1007/s00246-024-03737-w","DOIUrl":"https://doi.org/10.1007/s00246-024-03737-w","url":null,"abstract":"<p><p>This article provides a historical review and a current perspective on the procedures used to palliate cyanosis in ductal-dependent infants. Eighty years ago, Helen Taussig, Alfred Blalock, and Vivien Thomas developed the first effective treatment. The Blalock-Taussig-Thomas (BTT) shunt is the historical predecessor of both the contemporary-modified BTT shunt and interventional stenting of the Patent Ductus Arteriosus (PDA). The surgical shunt was firmly established therapy before catheterization was born, and PDA stenting was not possible until the technologies designed to address coronary heart disease were developed. Coronary stents and guidewires are currently used in all cases of PDA stenting. The momentum of long-established therapy and the lack of a purpose-built technology have inhibited clinical adoption of PDA stenting. Nevertheless, available clinical outcomes, though limited, appear to favor PDA stenting, and current first-line therapy may be shifting from the modified BTT shunt to PDA stenting. More definitive data should arise from a randomized controlled trial.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}