Effect of patient factors, center, and era on Fontan timing: An observational study using the Pediatric Health Information Systems Database
Authors' conclusion
After adjusting for patient-level characteristics there remains significant inter-center variation in Fontan timing. Age at Fontan has increased.
Study context
- Population
- Subjects who underwent Fontan operation 2007–2021 at centers in the Pediatric Health Information Systems database
- Participants
- 10,305 subjects · 47 centers
- Outcome
- Age at Fontan (patient characteristics, center, operation date as determinants)
Methodological detailsmulticentre, linear mixed-effects modeling
- Multicentre
- Linear mixed-effects modeling
Main finding
As reported in the abstract
Age at Fontan
- Median age at Fontan (IQR 2.6-4.4)
- 3.4 years
- Hypoplastic left heart syndrome (younger), 95% CI −5.5 to −3.3
- −4.4 months
- Concomitant conditions (younger), 95% CI −4.1 to −1.1
- −2.6 months
- Technology-dependence (older), 95% CI 3.1-6.1
- +4.6 months
- Black race (older), 95% CI 2.5-5.7
- +4.1 months
- Asian race (older), 95% CI 5.4-11.2
- +8.3 months
- Center share of variation (ICC 0.10, 95% CI 0.07-0.14); significant variation between centers
- 10%
- Center surgical volume not associated with Fontan timing
- P = .21
- Operation year: 3.1 month increase in age every 5 years
- +0.61 months 3.1 month (95% CI 0.48-0.75)
Observational data: associations, not effects.
Original publication
Effect of patient factors, center, and era on Fontan timing: An observational study using the Pediatric Health Information Systems Database. Am Heart J. Published 25 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it