Congenital heart diseaseCohort study
Partnership Model of Regionalized Care for Congenital Heart Disease in Resource-Limited Settings: Results From the ASSIST Project
- Retrospective cohort study
- before-after comparison
- contemporaneous comparison
Authors' conclusion
Interhospital partnership appears to be a useful and feasible method to deliver regionalized quality care for pediatric patients with CHD in resource-limited regions.
Study context
- Population
- Pediatric patients with congenital heart disease (CHD) treated in low-resource regions in China
- Participants
- 11,895 patients
- Exposure
- Post-ASSIST vs Shanghai Children's Medical Center
- Pre-ASSISTn = 3,333reference
- Post-ASSISTn = 1,566
- Shanghai Children's Medical Centern = 6,996
- Outcome
- Composite of:
- Postoperative mortality
- Multiorgan dysfunction
Main finding
As reported in the abstract
Postoperative mortality and multiorgan dysfunction
P = 0.13
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Primary outcome risk factors in low-resource regions — Lower family educational attainment vs Pre-ASSIST | 1.50 (1.21–1.85) | P < 0.001 | |
| Primary outcome risk factors in low-resource regions — Lower annual household income vs Pre-ASSIST | 1.65 (1.14–2.38) | P = 0.008 | |
| 0.512Odds ratio (log scale) |
| Outcome | Pre-ASSIST | Post-ASSIST | Shanghai Children's Medical Center | Estimate | P value |
|---|---|---|---|---|---|
| Delayed treatment (>6 months from recommendation to surgery) | 43.2% | 23.3% | Not reported in the abstract | P < 0.001 |
Primary outcome risk factors in low-resource regions
- Could be mitigated by the ASSIST project in a multivariable model
Case mix after vs before ASSIST
- More complex cases (35.5% versus 7.3%)
- P < 0.001
- Neonatal surgery (9.1% versus 1.5%)
- P < 0.001
Original publication
Partnership Model of Regionalized Care for Congenital Heart Disease in Resource-Limited Settings: Results From the ASSIST Project. Circulation. Published 30 June 2025. doi:10.1161/circulationaha.125.074298
Summarised from the published abstract; every number is checked against it