Congenital heart diseaseCohort study
Childhood Opportunity and Acute Interstage Outcomes: A National Pediatric Cardiology Quality Improvement Collaborative Analysis
- Retrospective cohort study
- multicentre
- registry-based
Authors' conclusion
Zip code COI level is associated with differences in preoperative risk factors and stage 1 palliation hospitalization characteristics. Acute interstage outcomes, although common across the spectrum of childhood opportunity, are not associated with COI level in an era of highly prevalent home monitoring programs.
Study context
- Population
- Infants discharged home after stage 1 palliation, National Pediatric Quality Improvement Collaborative Phase II registry (2016–2022)
- Participants
- 1,837 infants · 69 centers
- Exposure
- Childhood Opportunity Index levels
- Outcome
- Acute interstage outcomes: death or transplant listing, unplanned readmission, ICU admission, unplanned catheterization, reoperation
Main finding
As reported in the abstract
Acute interstage outcomes by COI level
- Death or transplant listing
- 101 (5%)
- Unplanned readmission
- 987 (53%)
- ICU admission
- 448 (24%)
- Catheterization
- 345 (19%)
- Reoperation
- 83 (5%)
Observational data: associations, not effects.
Further findings
Preoperative and stage 1 hospitalization characteristics by Childhood Opportunity Index (COI) level
- Birth weight increased with COI level
- P < 0.001
- Proximity to a surgical center at birth increased with COI level
- P = 0.02
- Stage 1 length of stay decreased with higher COI level
- P = 0.001
- Exclusive oral feeding at discharge increased with higher COI level
- P < 0.001
- Enrolled in home monitoring, all COI levels
- More than 98%
Race and ethnicity × childhood opportunity interaction
- No interaction between race and ethnicity and childhood opportunity in acute interstage outcomes
Original publication
Childhood Opportunity and Acute Interstage Outcomes: A National Pediatric Cardiology Quality Improvement Collaborative Analysis. Circulation. Published 19 June 2024. doi:10.1161/circulationaha.124.069127
Summarised from the published abstract; every number is checked against it