Neurodevelopmental Outcomes After Cardiac Surgery in Infancy
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- J. William Gaynor
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania;
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- Christian Stopp
- Boston Children’s Hospital, Boston, Massachusetts;
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- David Wypij
- Boston Children’s Hospital, Boston, Massachusetts;
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- Dean B. Andropoulos
- Texas Children’s Hospital, Houston, Texas;
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- Joseph Atallah
- Stollery Children’s Hospital and the Western Canadian Complex Pediatric Therapies Follow-up Program, Edmonton, Alberta, Canada;
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- Andrew M. Atz
- Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina;
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- John Beca
- Starship Children’s Hospital, Auckland, New Zealand;
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- Mary T. Donofrio
- Children’s National Medical Center, Washington, District of Columbia;
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- Kim Duncan
- Children’s Hospital and Medical Center, Omaha, Nebraska;
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- Nancy S. Ghanayem
- Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, Wisconsin;
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- Caren S. Goldberg
- Mott’s Children’s Hospital, Ann Arbor, Michigan;
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- Hedwig Hövels-Gürich
- University Hospital Aachen, Aachen, Germany;
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- Fukiko Ichida
- Toyama University Hospital, Toyama, Japan;
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- Jeffrey P. Jacobs
- Johns Hopkins All Children’s Heart Institute, St. Petersburg, Florida;
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- Robert Justo
- University of Queensland, Brisbane, Australia;
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- Beatrice Latal
- University Children’s Hospital Zurich, Zurich, Switzerland;
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- Jennifer S. Li
- Duke University Medical Center, Durham, North Carolina;
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- William T. Mahle
- Children’s Healthcare of Atlanta, Atlanta, Georgia;
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- Patrick S. McQuillen
- University of California, San Francisco, San Francisco, California;
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- Shaji C. Menon
- Primary Children’s Medical Center, Salt Lake City, Utah;
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- Victoria L. Pemberton
- National Heart, Lung, and Blood Institute, Bethesda, Maryland;
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- Nancy A. Pike
- Children’s Hospital Los Angeles, Los Angeles, California;
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- Christian Pizarro
- Alfred I. duPont Hospital for Children, Wilmington, Delaware;
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- Lara S. Shekerdemian
- The Royal Children’s Hospital, Melbourne, Australia;
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- Anne Synnes
- University of British Columbia, Vancouver, British Columbia, Canada; and
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- Ismee Williams
- New York-Presbyterian Morgan Stanley Children’s Hospital of New York, New York, New York
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- David C. Bellinger
- Boston Children’s Hospital, Boston, Massachusetts;
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- Jane W. Newburger
- Boston Children’s Hospital, Boston, Massachusetts;
書誌事項
- 公開日
- 2015-05-01
- 資源種別
- journal article
- DOI
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- 10.1542/peds.2014-3825
- 公開者
- American Academy of Pediatrics (AAP)
この論文をさがす
説明
<jats:sec> <jats:title>BACKGROUND:</jats:title> <jats:p>Neurodevelopmental disability is the most common complication for survivors of surgery for congenital heart disease (CHD).</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS:</jats:title> <jats:p>We analyzed individual participant data from studies of children evaluated with the Bayley Scales of Infant Development, second edition, after cardiac surgery between 1996 and 2009. The primary outcome was Psychomotor Development Index (PDI), and the secondary outcome was Mental Development Index (MDI).</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS:</jats:title> <jats:p>Among 1770 subjects from 22 institutions, assessed at age 14.5 ± 3.7 months, PDIs and MDIs (77.6 ± 18.8 and 88.2 ± 16.7, respectively) were lower than normative means (each P < .001). Later calendar year of birth was associated with an increased proportion of high-risk infants (complexity of CHD and prevalence of genetic/extracardiac anomalies). After adjustment for center and type of CHD, later year of birth was not significantly associated with better PDI or MDI. Risk factors for lower PDI were lower birth weight, white race, and presence of a genetic/extracardiac anomaly (all P ≤ .01). After adjustment for these factors, PDIs improved over time (0.39 points/year, 95% confidence interval 0.01 to 0.78; P = .045). Risk factors for lower MDI were lower birth weight, male gender, less maternal education, and presence of a genetic/extracardiac anomaly (all P < .001). After adjustment for these factors, MDIs improved over time (0.38 points/year, 95% confidence interval 0.05 to 0.71; P = .02).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS:</jats:title> <jats:p>Early neurodevelopmental outcomes for survivors of cardiac surgery in infancy have improved modestly over time, but only after adjustment for innate patient risk factors. As more high-risk CHD infants undergo cardiac surgery and survive, a growing population will require significant societal resources.</jats:p> </jats:sec>
収録刊行物
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- Pediatrics
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Pediatrics 135 (5), 816-825, 2015-05-01
American Academy of Pediatrics (AAP)
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キーワード
- Heart Defects, Congenital
- Male
- Biomedical and clinical sciences
- Time Factors
- Developmental Disabilities
- Clinical Sciences
- 610
- Neurodevelopmental outcomes
- Cardiovascular
- Medical and Health Sciences
- Pediatrics
- Nervous System
- neurodevelopmental outcomes
- 618
- Congenital
- Rare Diseases
- Postoperative Complications
- Clinical Research
- Risk Factors
- Cardiovascular Medicine and Haematology
- Psychology
- Humans
- International Cardiac Collaborative on Neurodevelopment (ICCON) Investigators
- Cardiac Surgical Procedures
- Heart Defects
- Pediatric
- Disability
- Biomedical and Clinical Sciences
- Psychology and Cognitive Sciences
- Congenital Heart Disease
- Health sciences
- Infant
- Cardiac surgery
- Perinatal Period - Conditions Originating in Perinatal Period
- Perinatology
- congenital heart defects
- and Child Health
- Quality Education
- Heart Disease
- Multivariate Analysis
- Congenital Structural Anomalies
- Female
- 2735 Pediatrics
- cardiopulmonary bypass
- cardiac surgery
詳細情報 詳細情報について
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- CRID
- 1360846644658049280
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- ISSN
- 10984275
- 00314005
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- PubMed
- 25917996
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- 資料種別
- journal article
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- データソース種別
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- Crossref
- KAKEN
- OpenAIRE