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Pediatric Cardiology

, Volume 38, Issue 7, pp 1350–1358 | Cite as

Transfer of Neonates with Critical Congenital Heart Disease Within a Regionalized Network

  • Michael F. Swartz
  • Jill M. Cholette
  • Jennifer M. Orie
  • Marshall L. Jacobs
  • Jeffrey P. Jacobs
  • George M. Alfieris
Original Article

Abstract

Regionalization of pediatric cardiac surgical care varies between and within states. In most geographic regions, at least some neonates with critical heart disease are transferred from their birth hospital to a different hospital for surgery. The impact of neonatal transfer for surgery, particularly over a considerable distance (>10 miles), has been largely unexplored. We sought to examine the impact of transferring neonates for cardiac surgery. We queried the New York State Cardiac Surgery database (2005–2014) from a single institution to identify neonates born within the cardiac surgery center and those transferred for surgery. Outcomes were compared between groups, with subgroup analysis of neonates with single ventricle anatomy. 113 surgical neonates were born at the cardiac surgery center, and 268 were transferred to the cardiac surgery center. Median transfer distance was 91 (IQR 73, 94) miles. Age at operation and the need for preoperative ventilation were significantly lower in neonates born at the cardiac surgery center. In addition, single ventricle anatomy was more prevalent among those born at the cardiac surgery center (48.7 vs. 31.3%; p = 0.001). However, postoperative outcomes were the same—30-day survival was similar across groups (birth: 89% vs. transfer: 90%; p = 0.7), and for those with single ventricle palliation (birth: 81% vs. transfer: 81%; p = 0.9). Within our regionalized network, we found no difference in 30-day survival between neonates either born or transferred to a cardiac surgery center, which supports the use of a regionalized network of hospitals to the care of children with congenital heart disease.

Keywords

Neonate Transfer Regionalization Critical congenital heart disease 

Notes

Funding

There was no institutional or outside funding used for this study.

Compliance with Ethical Standards

Conflicts of interest

All authors declare that they have no conflict of interest with the following manuscript.

Informed Consent

Following institutional IRB review, informed consent was waived due to the minimal risks associated with this review.

Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and or the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable standards.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Pediatric Cardiac Consortium of Upstate New YorkNew YorkUSA
  2. 2.University of Rochester Medical CenterRochesterUSA
  3. 3.Division of Cardiac SurgeryJohns Hopkins UniversityBaltimoreUSA
  4. 4.Division of Cardiac SurgeryJohns Hopkins All Children’s Heart InstituteSt. PetersburgUSA
  5. 5.Strong Memorial HospitalRochesterUSA

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