Sustained Improvement in Interstage Survival and Outcomes Within the National Pediatric Cardiology Quality Improvement Collaborative
Authors' conclusion
National Pediatric Cardiology Quality Improvement Collaborate sustained significant improvements in interstage outcomes through continued adherence to improvement processes, collaborative learning, and promoting best practices over time, including utilization of digoxin and NEONATE score.
Study context
- Population
- Infants with hypoplastic left heart syndrome enrolled in the National Pediatric Cardiology Quality Improvement Collaborate clinical registry who underwent stage 1 surgical palliation and were discharged home during the interstage periodenrolled from 77 centers
- Participants
- 5,495 infants
- Exposure
- Phase 1 and phase 2
- Phase 1n = 2,199
- Phase 2n = 3,296
- Outcome
- Interstage survival
Methodological detailsmulticenter, statistical process control
- Multicenter
- Statistical process control
Main finding
As reported in the abstract
Phase 2
94.8%
Observational data: associations, not effects.
Further findings
RV-PA conduit · higher prevalence in phase 2
P < 0.001
Digoxin prescription · higher in phase 2
P < 0.001
Length of stay · longer in phase 2
P < 0.001
Median
| Outcome | Phase 1 | Phase 2 | P value |
|---|---|---|---|
| NEONATE scoreLower in phase 2 | 9 | 3 | P < 0.001 |
Major adverse event readmissions
- Major adverse event readmissions declined early in phase 2 and were maintained
- 1.74 versus 0.9/100 interstage patients
Adequate growth (mean weight Z score at stage 2 admission)
- Statistically different but clinically stable over time; mean weight Z score at stage 2 admission
- −1.5 versus −1.42; P <0.019
Cohort characteristics
- Female
- 38.7%
- Major syndrome
- 11.2%
Original publication
Sustained Improvement in Interstage Survival and Outcomes Within the National Pediatric Cardiology Quality Improvement Collaborative. Circ Popul Health Outcomes. Published 2 November 2026. doi:10.
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