Risk of in-hospital Deterioration for Children with Single Ventricle Physiology

AbstractChildren with single ventricle physiology (SV) are at high risk of in-hospital morbidity and mortality. Identifying children at risk for deterioration may allow for earlier escalation of care and subsequently decreased mortality.We conducted a retrospective chart review of all admissions to the pediatric cardiology non-ICU service from 2014 to 2018 for children  <  18 years old. We defined clinical deterioration as unplanned transfer to the ICU or inpatient mortality. We selected children with SV by diagnosis codes and defined infants as children <  1 year old. We compared demographic, vital sign, and lab values between infants with and without a deterioration event. We evaluated vital sign and medical therapy changes before deterioration events.Among infants with SV (129 deterioration events over 225 admissions, overall 25% with hypoplastic left heart syndrome), those who deteriorated were younger (p  = 0.001), had lower baseline oxygen saturation (p = 0.022), and higher baseline respiratory rate (p = 0.022), heart rate (p = 0.023), and hematocrit (p = 0.008). Median Duke Pediatric Early Warning Score increased prior to deterioration (p <  0.001). Deterioration was associated with administration of additional oxygen support (p = 0.012), a fluid bolus (p <  0.001), antibiotics (p <  0.001), vasopressor support (p = 0.009), and red blood cell transfusion (p <  0.001).Infants with SV are at high risk ...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research