N. Shahi1, R. Phillips1, M. Meier2, J. Kaufman3, S. Moulton1 1Children’s Hospital Colorado,Pediatric Surgery,Aurora, CO, USA 2University Of Colorado Denver,Center For Research In Outcomes For Children’s Surgery (ROCS) |Adult And Child Consortium For Health Outcomes Research And Delivery Science (ACCORDS),Aurora, CO, USA 3Children’s Hospital Colorado,Pediatric Cardiology,Aurora, CO, USA
Introduction:
Infants with congenital heart disease (CHD) often exhibit increased metabolic demands, and many will require a gastrostomy to achieve adequate nutritional intake. There is a paucity of data comparing cyanotic (CCHD) versus acyanotic (ACHD) infants in terms of operative risks and overall complications of gastrostomy placement. We hypothesized that patients with CCHD would have greater nutritional impairment at the time of gastrostomy placement and a higher rate of gastrostomy associated complications when compared to infants with ACHD.
Methods:
We retrospectively reviewed patients who underwent gastrostomy button placement following cardiac surgery for CHD between 2012 and 2018. We stratified patients into CCHD and ACHD. Patient data related to cardiac disease and surgery were extracted from the STS database and merged with clinical data related to gastrostomy placement and complications. A full multivariate model was developed to compare the clinically relevant covariates and gastrostomy. complications.
Results:
Table 1 shows the demographic data for all 259 children, of which 84 had CCHD. There were no significant differences in baseline weight or preoperative albumin levels between the two groups. As expected, patients with cyanotic heart disease had a higher post-operative mortality rate (p=0.045), higher STAT scores (p<0.0001), and a lower incidence of co-morbid syndromes (p= 0.0005). There was a higher rate of granulation tissue formation in ACHD patients (48% vs. 22.6%, p= 0.0002). There was no difference in other gastrostomy button-related complications including leakage, wound infection, or dislodgement.
Conclusion:
Patients with CCHD have similar baseline nutritional status compared to infants with ACHD. We found no difference in gastrostomy complication rates between the two groups, with the notable exception of granulation tissue formation. Based on this study, the diagnosis of CCHD should not deter or delay gastrostomy button placement.
