Mohamed F Elsisy, George T Nicholson, Elizabeth H Stephens, Gayathri Sreenivasan, Arpit Gupta
{"title":"早产儿动脉导管未闭早期与晚期经导管闭合的住院结果。","authors":"Mohamed F Elsisy, George T Nicholson, Elizabeth H Stephens, Gayathri Sreenivasan, Arpit Gupta","doi":"10.1177/19345798251350986","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundTranscatheter closure of patent ductus arteriosus (PDA) in small, premature infants is increasingly performed in the contemporary practice. Data regarding optimal timing of PDA closure are scarce. We therefore decided to compare morbidity and mortality of early and late device closure in preterm infants.MethodsHospitalizations of 166,583 newborn infants diagnosed with PDA were identified from the Kids' Inpatient Database (KID) in 2009, 2012, 2016, and 2019. Of these, 299 preterm infants (gestational age (GA) ≤32 weeks, birth weight <1500 grams) underwent percutaneous PDA closure. Characteristics and periprocedural outcomes were compared between early (≤30 days) (<i>n</i> = 120) and late PDA closure (>30 days) (<i>n</i> = 179).ResultsMean age (±standard deviation) for early PDA closure was 18.6 days ± 7 and 67.3 days ± 36.5 in late PDA closure. Comorbidities including respiratory distress syndrome/bronchopulmonary dysplasia, heart failure, and pulmonary hypertension were comparable between the two groups. There was no difference in mortality or referral for surgical ligation between early and late closure. Postprocedural vascular complications were low, but higher in patients with early PDA closure (3.3% vs 0%; <i>p</i> = 0.025). While the total length of hospital stay was longer in late PDA closure group (121.1 days ± 51.7 vs 81.5 days ± 48.8; <i>p</i> = <0.01), postprocedural length of stay was paradoxically longer in the early closure group (69 days ± 43.6 vs 57.5 days ± 43, <i>p</i> = 0.03).ConclusionThere was no statistical difference in in-hospital mortality; however, there is a trend toward higher mortality in the early closure group. Major periprocedural complications are comparable between early and late PDA closure, except vascular complications that were higher with early PDA closure.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251350986"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"In-hospital outcomes of early versus late transcatheter closure of patent ductus arteriosus in preterm infants.\",\"authors\":\"Mohamed F Elsisy, George T Nicholson, Elizabeth H Stephens, Gayathri Sreenivasan, Arpit Gupta\",\"doi\":\"10.1177/19345798251350986\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>BackgroundTranscatheter closure of patent ductus arteriosus (PDA) in small, premature infants is increasingly performed in the contemporary practice. Data regarding optimal timing of PDA closure are scarce. We therefore decided to compare morbidity and mortality of early and late device closure in preterm infants.MethodsHospitalizations of 166,583 newborn infants diagnosed with PDA were identified from the Kids' Inpatient Database (KID) in 2009, 2012, 2016, and 2019. Of these, 299 preterm infants (gestational age (GA) ≤32 weeks, birth weight <1500 grams) underwent percutaneous PDA closure. Characteristics and periprocedural outcomes were compared between early (≤30 days) (<i>n</i> = 120) and late PDA closure (>30 days) (<i>n</i> = 179).ResultsMean age (±standard deviation) for early PDA closure was 18.6 days ± 7 and 67.3 days ± 36.5 in late PDA closure. Comorbidities including respiratory distress syndrome/bronchopulmonary dysplasia, heart failure, and pulmonary hypertension were comparable between the two groups. There was no difference in mortality or referral for surgical ligation between early and late closure. Postprocedural vascular complications were low, but higher in patients with early PDA closure (3.3% vs 0%; <i>p</i> = 0.025). While the total length of hospital stay was longer in late PDA closure group (121.1 days ± 51.7 vs 81.5 days ± 48.8; <i>p</i> = <0.01), postprocedural length of stay was paradoxically longer in the early closure group (69 days ± 43.6 vs 57.5 days ± 43, <i>p</i> = 0.03).ConclusionThere was no statistical difference in in-hospital mortality; however, there is a trend toward higher mortality in the early closure group. Major periprocedural complications are comparable between early and late PDA closure, except vascular complications that were higher with early PDA closure.</p>\",\"PeriodicalId\":16537,\"journal\":{\"name\":\"Journal of neonatal-perinatal medicine\",\"volume\":\" \",\"pages\":\"19345798251350986\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neonatal-perinatal medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/19345798251350986\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neonatal-perinatal medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19345798251350986","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景:经导管关闭动脉导管未闭(PDA)在当代的实践中越来越多地应用于小早产儿。关于最佳PDA关闭时间的数据很少。因此,我们决定比较早产儿早期和晚期器械关闭的发病率和死亡率。方法从2009年、2012年、2016年和2019年儿童住院数据库(KID)中识别出166583例确诊为PDA的新生儿住院情况。其中,299例早产儿(胎龄(GA)≤32周,出生体重n = 120)和晚期PDA关闭(bb0 30天)(n = 179)。结果早期PDA闭合的平均年龄(±标准差)为18.6天±7天,晚期PDA闭合的平均年龄为67.3天±36.5天。合并症包括呼吸窘迫综合征/支气管肺发育不良、心力衰竭和肺动脉高压在两组之间具有可比性。早期和晚期结扎在死亡率和转诊方面没有差异。术后血管并发症较低,但早期PDA闭合患者较高(3.3% vs 0%;P = 0.025)。而PDA晚期闭合组总住院时间更长(121.1天±51.7天vs 81.5天±48.8天);P = P = 0.03)。结论两组住院死亡率差异无统计学意义;然而,早期闭合组的死亡率有较高的趋势。主要围手术期并发症在早期和晚期PDA关闭之间是相似的,除了血管并发症在早期PDA关闭时更高。
In-hospital outcomes of early versus late transcatheter closure of patent ductus arteriosus in preterm infants.
BackgroundTranscatheter closure of patent ductus arteriosus (PDA) in small, premature infants is increasingly performed in the contemporary practice. Data regarding optimal timing of PDA closure are scarce. We therefore decided to compare morbidity and mortality of early and late device closure in preterm infants.MethodsHospitalizations of 166,583 newborn infants diagnosed with PDA were identified from the Kids' Inpatient Database (KID) in 2009, 2012, 2016, and 2019. Of these, 299 preterm infants (gestational age (GA) ≤32 weeks, birth weight <1500 grams) underwent percutaneous PDA closure. Characteristics and periprocedural outcomes were compared between early (≤30 days) (n = 120) and late PDA closure (>30 days) (n = 179).ResultsMean age (±standard deviation) for early PDA closure was 18.6 days ± 7 and 67.3 days ± 36.5 in late PDA closure. Comorbidities including respiratory distress syndrome/bronchopulmonary dysplasia, heart failure, and pulmonary hypertension were comparable between the two groups. There was no difference in mortality or referral for surgical ligation between early and late closure. Postprocedural vascular complications were low, but higher in patients with early PDA closure (3.3% vs 0%; p = 0.025). While the total length of hospital stay was longer in late PDA closure group (121.1 days ± 51.7 vs 81.5 days ± 48.8; p = <0.01), postprocedural length of stay was paradoxically longer in the early closure group (69 days ± 43.6 vs 57.5 days ± 43, p = 0.03).ConclusionThere was no statistical difference in in-hospital mortality; however, there is a trend toward higher mortality in the early closure group. Major periprocedural complications are comparable between early and late PDA closure, except vascular complications that were higher with early PDA closure.