Center-level factors associated with shorter length of stay following stage 1 palliation: An analysis of the national pediatric cardiology quality improvement collaborative registry
Authors' conclusion
Modifiable center-level practices may be targets to standardize practice and reduce overall LOS across centers.
Study context
- Population
- Infants after stage 1 single ventricle palliation (S1P), National Pediatric Cardiology Quality Improvement Collaborative Phase II registry
- Participants
- 2,037 infants · 47 sites
- Exposure
- Centres by quartile of median centre length of stay (LOS)
- Outcome
- Patient-level LOS (days alive and out of hospital before S2P as balancing measure)
Methodological detailsmulticentre registry analysis, multivariable regression adjusted for case mix
- Multicentre registry analysis
- Multivariable regression adjusted for case mix
Main finding
As reported in the abstract
LOS
P < 0.001
Observational data: associations, not effects.
Further findings
Centre-level factors associated with shorter-LOS centres (multivariable)
| Comparison | aOR (CI) | |
|---|---|---|
| Increased Norwood with RV to pulmonary artery conduit | 2.65 (1.1–6.37) | |
| Fewer additional cardiac operations | 0.46 (0.22–0.93) | |
| Increased NG tubes rather than G tubes | 7.03 (1.95–25.42) | |
| 0.050.21520Adjusted odds ratio (log scale) |
| Outcome | aOR (per minute) (CI) | |
|---|---|---|
| Centre-level factors associated with shorter-LOS centres (multivariable)Shorter bypass time | 0.99 (0.98,1.0) | |
| 0.512Adjusted odds ratio (log scale) |
Pre-S2P days alive and out of hospital vs LOS
- Shorter LOS correlated with more pre-S2P days alive and out of hospital (correlation coefficient)
- −0.48, P < .001
- After accounting for readmissions
Mortality before S2P
- Mortality prior to S2P did not differ across quartiles
Original publication
Center-level factors associated with shorter length of stay following stage 1 palliation: An analysis of the national pediatric cardiology quality improvement collaborative registry. Am Heart J. Published 10 August 2023. doi:10.
Summarised from the published abstract; every number is checked against it