Abstract:
The objective of this study was to identify patient and hospitalization
characteristics associated with in-hospital mortality in infants with
truncus arteriosus. We conducted a retrospective analysis of a large
administrative database, the National Inpatient Sample dataset of the
Healthcare Cost and Utilization Project for the years 2002–2017. We also
sought to evaluate the resource utilization in the subgroup of subjects
with truncus arteriosus and 22q11.2 deletion syndrome. Neonates with
truncus arteriosus were identified by ICD-9 and ICD-10 codes. Hospital
and patient factors associated with inpatient mortality were analyzed.
Overall, 3009 neonates met inclusion criteria; a total of 326 patients
died during the hospitalization (10.8%). Extracorporeal membrane
oxygenation utilization was 7.1 %. Univariate and multivariate logistic
regression analyses were used to identify risk factors for in-hospital
mortality. Independent risk factors for mortality were prematurity (aOR
= 2.43, 95% CI: 1.40–4.22, p = 0.002), diagnosis of stroke (aOR =
26.2, 95% CI: 10.1–68.1, p < 0.001), necrotizing
enterocolitis (aOR = 3.10, 95% CI: 1.24–7.74, p = 0.015) and presence of
venous thrombosis (aOR = 13.5, 95% CI: 6.7–27.2, p < 0.001).
Patients who received ECMO support or had cardiac catheterization
procedure during the hospitalization had increased odds of mortality
(aOR = 82.0, 95% CI: 44.5–151.4, p < 0.001, and aOR = 1.65,
95% CI: 0.98–2.77, p = 0.060, respectively). 22q11.2 deletion syndrome
was associated with an inverse risk of death despite having more
non-cardiac comorbidities; this patient subpopulation also had higher
length of stay and increased cost of hospitalization.