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Impaired weight gain predicts risk of late death after surgery for congenital heart defects.
  1. Leif Torvald Eskedal (leif.eskedal{at}sshf.no)
  1. Sørlandet Regional Hospital, Norway
    1. Petter Skjalg Hagemo (petter.hagemo{at}rikshospitalet.no)
    1. Rikshospitalet-Radiumhospitalet Medical Centre, Norway
      1. Egil Seem (egil.seem{at}rikshospitalet.no)
      1. Rikshospitalet-Radiumhospitalet Medical Centre, Norway
        1. Anne Eskild (anne.eskild{at}medisin.uio.no)
        1. Akershus University Hospital, Norway
          1. Milada Cvancarova (milada.smaastuen{at}rikshospitalet.no)
          1. Rikshospitalet-Radiumhospitalet Medical Centre, Norway
            1. Stephen Seiler (stephen.seiler{at}hia.no)
            1. Agder University College, Norway
              1. Erik Thaulow (erik.thaulow{at}rikshospitalet.no)
              1. Rikshospitalet-Radiumhospitalet Medical Centre, Norway

                Abstract

                Objective: First, to describe long term somatic growth in terms of weight for age in children operated for congenital heart defects who die late (after the first 30 postoperative days), and second, to study the relation between postoperative weight gain and survival after congenital heart defect surgery.

                Design: Nested case- control study.

                Patients: 80 children born 1990- 2002 suffered from late death after surgery for congenital heart defects at Rikshospitalet, Norway. Weight data could be obtained in 74. Of these, 31 children with no extra-cardiac anomaly were defined as cases, and 31 surviving children with similar surgical complexity were defined as controls.

                Results: In the 74 children who died late, mean weight for age converted to z scores at birth, at last operation and at time of last recorded weight were 0.12, - 1.31 and -2.09. In the 31 children defined as cases, the same weight z scores were 0.07, -1.21 and -2.01, compared to 0.05, -1.10 and -0.99 in the 31 matched controls. The odds ratio (OR) for death was 13.5 (95% CI: 3.6-51.0) if there was a decrease in weight z score of > 0.67 after the last operation. Median follow up time after operation was 5.7 months.

                Conclusions: A decrease in weight for age the first months after surgery for congenital heart defects of more than 0.67 z scores, corresponding to a downward percentile crossing through at least one of the displayed percentile lines on standard growth charts, is strongly related to late mortality in children operated for congenital heart defects.

                • Congenital heart defects
                • Late outcome
                • Somatic growth
                • Surgery

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