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Tetralogy of Fallot Repair in Developing Countries: International Quality Improvement Collaborative

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dc.creatorSandoval, Nestorspa
dc.creatorCarreño, Marisolspa
dc.creatorNovick, William M.spa
dc.creatorAgarwal, Ravispa
dc.creatorAhmed, Iftikharspa
dc.creatorBalachandran, Rakhispa
dc.creatorBalestrini, Mariaspa
dc.creatorCherian, K.M.spa
dc.creatorCroti, Ulissesspa
dc.creatorDu, Xinweispa
dc.creatorGauvreau, Kimberleespa
dc.creatorDo Thi Cam Giangspa
dc.creatorShastri, Ramkinkarspa
dc.creatorJenkins, Kathy J.spa
dc.date.accessioned2020-05-25T23:56:35Z
dc.date.available2020-05-25T23:56:35Z
dc.date.created2018spa
dc.description.abstractBackground: Isolated reports from low- and middle-income countries (LMICs) for surgical results in tetralogy of Fallot (TOF) are available. The International Quality Improvement Collaborative for Congenital Heart Disease (IQIC) seeks to improve surgical results promoting reductions in infection and mortality in LMICs. Methods: All cases of TOF in the IQIC database performed between 2010 and 2014 at 32 centers in 20 LMICs were included. Excluded from the analysis were TOF with any associated lesions. A logistic regression analysis was performed to identify risk factors for in-hospital mortality after surgery for TOF. Results: A total of 2,164 patients were identified. There were 1,839 initial primary repairs, 200 with initial systemic-to-pulmonary artery shunt, and 125 underwent secondary repair after initial palliation. Overall mortality was 3.6% (78 of 2,164), initial primary repair was 3.3% (60 of 1,839), initial systemic-to-pulmonary artery shunt was 8.0% (16 of 200), and secondary repair was 1.6% (2 of 125; p = 0.003). Major infections occurred in 5.9% (128 of 2,164) of the entire cohort. Risk factors for death after the initial primary repair were oxygen saturation less than 90% and weight/body mass index for age below the fifth percentile (p less than 0.001). The initial primary repair occurred after age 1 year in 54% (991 of 1,839). Older age at initial primary repair was not a risk factor for death (p = 0.21). Conclusions: TOF patients are often operated on after age 1 year in LMICs. Unlike in developed countries, older age is not a risk factor for death. Nutritional and hypoxemic status were associated with higher mortality and infection. This information fills a critical knowledge gap for surgery in LMIC. © 2018 The Society of Thoracic Surgeonseng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1016/j.athoracsur.2018.05.080
dc.identifier.issn34975
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/22467
dc.language.isoengspa
dc.publisherElsevier USAspa
dc.relation.citationEndPage1451
dc.relation.citationIssueNo. 5
dc.relation.citationStartPage1446
dc.relation.citationTitleAnnals of Thoracic Surgery
dc.relation.citationVolumeVol. 106
dc.relation.ispartofAnnals of Thoracic Surgery, ISSN:34975, Vol.106, No.5 (2018); pp. 1446-1451spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85054140649&doi=10.1016%2fj.athoracsur.2018.05.080&partnerID=40&md5=513e8519728e4e932a2e8c41c21a1df0spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordAdolescentspa
dc.subject.keywordArticlespa
dc.subject.keywordBody massspa
dc.subject.keywordBody weightspa
dc.subject.keywordChildspa
dc.subject.keywordDeveloping countryspa
dc.subject.keywordFallot tetralogyspa
dc.subject.keywordFemalespa
dc.subject.keywordHospital mortalityspa
dc.subject.keywordHumanspa
dc.subject.keywordInfantspa
dc.subject.keywordInfectionspa
dc.subject.keywordMajor clinical studyspa
dc.subject.keywordMalespa
dc.subject.keywordMortality ratespa
dc.subject.keywordNewbornspa
dc.subject.keywordOxygen saturationspa
dc.subject.keywordPriority journalspa
dc.subject.keywordRisk factorspa
dc.subject.keywordSystemic pulmonary shuntspa
dc.subject.keywordTotal quality managementspa
dc.subject.keywordTreatment outcomespa
dc.subject.keywordCause of deathspa
dc.subject.keywordClinical trialspa
dc.subject.keywordDiagnostic imagingspa
dc.subject.keywordFactual databasespa
dc.subject.keywordFallot tetralogyspa
dc.subject.keywordHeart surgeryspa
dc.subject.keywordHospital mortalityspa
dc.subject.keywordInternational cooperationspa
dc.subject.keywordKaplan meier methodspa
dc.subject.keywordMortalityspa
dc.subject.keywordMulticenter studyspa
dc.subject.keywordProceduresspa
dc.subject.keywordRetrospective studyspa
dc.subject.keywordRisk assessmentspa
dc.subject.keywordSurvival analysisspa
dc.subject.keywordCardiac surgical proceduresspa
dc.subject.keywordCause of deathspa
dc.subject.keywordDatabaseseng
dc.subject.keywordDeveloping countriesspa
dc.subject.keywordFemalespa
dc.subject.keywordHospital mortalityspa
dc.subject.keywordHumansspa
dc.subject.keywordInfantspa
dc.subject.keywordInfanteng
dc.subject.keywordInternationalityspa
dc.subject.keywordKaplan-meier estimatespa
dc.subject.keywordMalespa
dc.subject.keywordRetrospective studiesspa
dc.subject.keywordRisk assessmentspa
dc.subject.keywordSurvival analysisspa
dc.subject.keywordTetralogy of fallotspa
dc.subject.keywordTreatment outcomespa
dc.titleTetralogy of Fallot Repair in Developing Countries: International Quality Improvement Collaborativespa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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