Abstract
Background
We investigated the effect of hospital volume on percutaneous closure of atrial septal defect/patent foramen ovale (ASD) among pediatric patients.
Methods
We identified patients undergoing percutaneous closure of ASD with device using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure code 35.52 from the National Inpatient Sample, years 2002–2011. Patients with age ≤ 18 years and primary diagnosis code 745.5 for ASD were included. Hospital volume was calculated using unique identification numbers and divided into tertiles for analysis. Multivariate regression analysis was performed to determine independent predictors of procedure-related complications which were coded using specific codes released by Healthcare Cost and Utilization Project.
Results
6162 percutaneous ASD closure procedures were analyzed. There was no mortality associated with percutaneous ASD closure. Cardiac complications (9.5%) were most common. On multivariate analysis, age increment of 3 years decreased the odds of developing complications (OR 0.83, 95% CI 0.79–0.87, P < 0.001). Odds of developing complications in the 2nd (OR 0.74, 95% CI 0.62–0.89, P = 0.007) and 3rd tertiles (OR 0.34, 95% CI 0.27–0.42, P < 0.001) were lower as compared to the 1st tertile of hospital volume.
Conclusion
Increasing annual hospital volume is an independent predictor of lower complication rates in percutaneous ASD closure cases with no associated mortality in pediatric patients.
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BP conceptualized and designed the study, acquired the data, analyzed the data, and drafted the initial manuscript. PA, KV and PV acquired the data, analyzed and interpreted the data, and revised the manuscript. LA interpreted the data, and drafted the initial manuscript. AS interpreted the data, and revised the manuscript. BZC conceptualized and designed the study, interpreted the results, critically reviewed and revised the manuscript. All authors approved the final version to be published.
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This study was conducted using a de-identified national dataset. No human subjects were involved.
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No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. The authors have no conflicts of interest relevant to this article to disclose.
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Bhatt, P., Patel, A., Kumar, V. et al. Impact of hospital volume on outcomes of percutaneous ASD/PFO closure in pediatric patients. World J Pediatr 14, 364–372 (2018). https://doi.org/10.1007/s12519-018-0120-3
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DOI: https://doi.org/10.1007/s12519-018-0120-3