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Biomarkers Improve Prediction of 30-day Unplanned Readmission or Mortality after Pediatric Congenital Heart Surgery
- Publication Year :
- 2019
-
Abstract
- Objective:To evaluate the association between novel pre- and post-operative biomarker levels and 30-day unplanned readmission or mortality after paediatric congenital heart surgery.Methods:Children aged 18 years or younger undergoing congenital heart surgery (n = 162) at Johns Hopkins Hospital from 2010 to 2014 were enrolled in the prospective cohort. Collected novel pre- and post-operative biomarkers include soluble suppression of tumorgenicity 2, galectin-3, N-terminal prohormone of brain natriuretic peptide, and glial fibrillary acidic protein. A model based on clinical variables from the Society of Thoracic Surgery database was developed and evaluated against two augmented models.Results:Unplanned readmission or mortality within 30 days of cardiac surgery occurred among 21 (13%) children. The clinical model augmented with pre-operative biomarkers demonstrated a statistically significant improvement over the clinical model alone with a receiver-operating characteristics curve of 0.754 (95% confidence interval: 0.65–0.86) compared to 0.617 (95% confidence interval: 0.47–0.76; p-value: 0.012). The clinical model augmented with pre- and post-operative biomarkers demonstrated a significant improvement over the clinical model alone, with a receiver-operating characteristics curve of 0.802 (95% confidence interval: 0.72–0.89; p-value: 0.003).Conclusions:Novel biomarkers add significant predictive value when assessing the likelihood of unplanned readmission or mortality after paediatric congenital heart surgery. Further exploration of the utility of these novel biomarkers during the pre- or post-operative period to identify early risk of mortality or readmission will aid in determining the clinical utility and application of these biomarkers into routine risk assessment.
- Subjects :
- Heart Defects, Congenital
Male
medicine.medical_specialty
Time Factors
Adolescent
Databases, Factual
Galectin 3
030204 cardiovascular system & hematology
Patient Readmission
Risk Assessment
Article
03 medical and health sciences
0302 clinical medicine
Natriuretic Peptide, Brain
medicine
Risk of mortality
Humans
Postoperative Period
Prospective Studies
Cardiac Surgical Procedures
Prospective cohort study
Child
Maryland
business.industry
Infant, Newborn
Infant
General Medicine
Brain natriuretic peptide
Confidence interval
Peptide Fragments
Surgery
Cardiac surgery
Logistic Models
030228 respiratory system
ROC Curve
Cardiothoracic surgery
Child, Preschool
Pediatrics, Perinatology and Child Health
Biomarker (medicine)
Female
Cardiology and Cardiovascular Medicine
Risk assessment
business
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 10479511
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....59b523e617d2fffe8393cf7c512d237b