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Outcomes and Health Care Resource Utilization in Pediatric Congenital Heart Disease Patients Undergoing Non-Cardiac Procedures

Recruiting
Conditions
Congenital Heart Disease in Children
Registration Number
NCT04604418
Lead Sponsor
Boston Children's Hospital
Brief Summary

The incidence of moderate to severe congenital heart disease (CHD) in the United States is estimated to be 6 per 1000 live-born full term infants. Recent advances in pediatric cardiology, surgery and critical care have significantly improved the survival rates of patients with CHD leading to an increase in prevalence in both children and adults. Children with CHD significant enough to require cardiac surgery frequently also undergo non-cardiac surgical procedures. Analysis of the Pediatric Health Information System database between 2004 and 2012 demonstrated that 41% of children who had undergone surgery to correct CHD in the first year of life also underwent at least one non-cardiac surgery by age 5. With this increased demand for non-cardiac procedures, anesthesiologists, pediatricians and other healthcare providers will encounter patients with repaired or unrepaired CHD and other cardiac diseases in their practice.

However, the information provided by national databases lack granularity and the information from single institutional data is limited.

This project aims to address this knowledge gap in quantifying the risk for cardiac patients coming for noncardiac procedures and identify the health care resource utilization and system to best care for this patient population. To conduct this study, we will create a multi-institutional collaboration between large and small centers to create a unique dataset spanning all the different variables that need to be considered in risk prediction for these patients including patient variables, hospital setting, and providers. The aggregate multiinstitutional data set may be used for benchmarking for national quality improvement efforts.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
10000
Inclusion Criteria
  1. Males or females ages birth to 21 years.
  2. Patients diagnosed with congenital heart disease
  3. Patients undergoing a noncardiac procedure (surgical or nonsurgical)
Exclusion Criteria
  1. Patients with congenial heart disease undergoing a cardiac surgical procedure including pacemakers.
  2. Patients with congenital heart disease undergoing a catheterization(diagnostic or interventional) or an electrophysiology study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Intraoperative cardiac eventDuring the perioperative period
Mortalityduring the procedure and up to 30-days following the procedure

Death

Intensive Care Unit admissionfollowing the procedure and up to 72 hours

The postoperative location of the patient is in the intensive care unit unexpectedly

Postoperative mechanical supportfollowing the procedure and up to 72 hours

Patient required a ventilator or noninvasive positive pressure ventilation

Secondary Outcome Measures
NameTimeMethod
Cardiac arrestduring the procedure and up to 72 hours

Patient required cardiopulmonary ressuscitation

Neurologic injuryFollowing the procedure and up to 72 hours

Defined as stroke or seizure by the provider

Renal InjuryFollowing the procedure and up to 72 hours

Defined based on creatinine and glomerular filtration

Readmission Cardiac arrest: during the procedure and up to 72 hours Neurologic injury (stroke, seizure) following the procedure and up to 72 hours Renal injury following the procedure and up to 72 hoursfollowing the procedure and up to 72 hours

Patient was discharged after the procedure and needed to be readmitted to the hospital is defined as readmission

Trial Locations

Locations (10)

Children's Hospital of the King's Daughter

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Norfolk, Virginia, United States

University of California, Los Angeles

πŸ‡ΊπŸ‡Έ

Los Angeles, California, United States

Children's National Medical Center

πŸ‡ΊπŸ‡Έ

Washington, District of Columbia, United States

Children's Hospital of Philadelphia

πŸ‡ΊπŸ‡Έ

Philadelphia, Pennsylvania, United States

Texas Children's Hospital

πŸ‡ΊπŸ‡Έ

Houston, Texas, United States

Boston Children's Hospital

πŸ‡ΊπŸ‡Έ

Boston, Massachusetts, United States

Hospital for Sick Kids

πŸ‡¨πŸ‡¦

Toronto, Ontario, Canada

Children's Healthcare of Atlanta - Egleston Hospita

πŸ‡ΊπŸ‡Έ

Atlanta, Georgia, United States

University of Minnesota Medical Center

πŸ‡ΊπŸ‡Έ

Minneapolis, Minnesota, United States

Vanderbilt University Medical Center

πŸ‡ΊπŸ‡Έ

Nashville, Tennessee, United States

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