Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset
BackgroundMortality for infants with single ventricle congenital heart disease remains as high as 8% to 12% during the interstage period, the time between discharge after the Norwood procedure and before the stage II palliation. The objective of our study was to determine the association between dig...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.115.002566 |
| _version_ | 1818289507034726400 |
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| author | Matthew E. Oster Michael Kelleman Courtney McCracken Richard G. Ohye William T. Mahle |
| author_facet | Matthew E. Oster Michael Kelleman Courtney McCracken Richard G. Ohye William T. Mahle |
| author_sort | Matthew E. Oster |
| collection | DOAJ |
| description | BackgroundMortality for infants with single ventricle congenital heart disease remains as high as 8% to 12% during the interstage period, the time between discharge after the Norwood procedure and before the stage II palliation. The objective of our study was to determine the association between digoxin use and interstage mortality in these infants. Methods and ResultsWe conducted a retrospective cohort study using the Pediatric Heart Network Single Ventricle Reconstruction Trial public use dataset, which includes data on infants with single right ventricle congenital heart disease randomized to receive either a Blalock‐Taussig shunt or right ventricle‐to‐pulmonary artery shunt during the Norwood procedure at 15 institutions in North America from 2005 to 2008. Parametric survival models were used to compare the risk of interstage mortality between those discharged to home on digoxin versus those discharged to home not on digoxin, adjusting for center volume, ascending aorta diameter, shunt type, and socioeconomic status. Of the 330 infants eligible for this study, 102 (31%) were discharged home on digoxin. Interstage mortality for those not on digoxin was 12.3%, compared to 2.9% among those on digoxin, with an adjusted hazard ratio of 3.5 (95% CI, 1.1–11.7; P=0.04). The number needed to treat to prevent 1 death was 11 patients. There were no differences in complications between the 2 groups during the interstage period. ConclusionsDigoxin use in infants with single ventricle congenital heart disease is associated with significantly reduced interstage mortality. |
| first_indexed | 2024-12-13T02:13:22Z |
| format | Article |
| id | doaj.art-5fa6c29bc2a544c9aec51f7341f2de84 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T02:13:22Z |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-5fa6c29bc2a544c9aec51f7341f2de842022-12-22T00:02:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-01-015110.1161/JAHA.115.002566Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use DatasetMatthew E. Oster0Michael Kelleman1Courtney McCracken2Richard G. Ohye3William T. Mahle4Children's Healthcare of Atlanta, GAEmory University School of Medicine, Atlanta, GAEmory University School of Medicine, Atlanta, GAUniversity of Michigan Medical School, Ann Arbor, MIChildren's Healthcare of Atlanta, GABackgroundMortality for infants with single ventricle congenital heart disease remains as high as 8% to 12% during the interstage period, the time between discharge after the Norwood procedure and before the stage II palliation. The objective of our study was to determine the association between digoxin use and interstage mortality in these infants. Methods and ResultsWe conducted a retrospective cohort study using the Pediatric Heart Network Single Ventricle Reconstruction Trial public use dataset, which includes data on infants with single right ventricle congenital heart disease randomized to receive either a Blalock‐Taussig shunt or right ventricle‐to‐pulmonary artery shunt during the Norwood procedure at 15 institutions in North America from 2005 to 2008. Parametric survival models were used to compare the risk of interstage mortality between those discharged to home on digoxin versus those discharged to home not on digoxin, adjusting for center volume, ascending aorta diameter, shunt type, and socioeconomic status. Of the 330 infants eligible for this study, 102 (31%) were discharged home on digoxin. Interstage mortality for those not on digoxin was 12.3%, compared to 2.9% among those on digoxin, with an adjusted hazard ratio of 3.5 (95% CI, 1.1–11.7; P=0.04). The number needed to treat to prevent 1 death was 11 patients. There were no differences in complications between the 2 groups during the interstage period. ConclusionsDigoxin use in infants with single ventricle congenital heart disease is associated with significantly reduced interstage mortality.https://www.ahajournals.org/doi/10.1161/JAHA.115.002566congenitaldigoxinheart defectsmortalitypediatricssingle ventricle |
| spellingShingle | Matthew E. Oster Michael Kelleman Courtney McCracken Richard G. Ohye William T. Mahle Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease congenital digoxin heart defects mortality pediatrics single ventricle |
| title | Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset |
| title_full | Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset |
| title_fullStr | Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset |
| title_full_unstemmed | Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset |
| title_short | Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset |
| title_sort | association of digoxin with interstage mortality results from the pediatric heart network single ventricle reconstruction trial public use dataset |
| topic | congenital digoxin heart defects mortality pediatrics single ventricle |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.115.002566 |
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