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The impact of femoral arterial thrombosis in paediatric cardiac catheterisation: a national study

Published online by Cambridge University Press:  08 November 2016

Jina Kim ,
Zhifei Sun ,
Ehsan Benrashid ,
Kevin W. Southerland ,
Jeffrey H. Lawson ,
Gregory A. Fleming ,
Kevin D. Hill  and
Elisabeth T. Tracy
Jina Kim*
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America
Zhifei Sun
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America
Ehsan Benrashid
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America
Kevin W. Southerland
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America
Jeffrey H. Lawson
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America
Gregory A. Fleming
Affiliation:
Department of Cardiology, Duke University Medical Center, Durham, North Carolina, United States of America
Kevin D. Hill
Affiliation:
Department of Cardiology, Duke University Medical Center, Durham, North Carolina, United States of America
Elisabeth T. Tracy
Affiliation:
Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America
*
Correspondence to: J. Kim, MD, Department of Surgery, Duke University Medical Center, Box 3443, Durham, NC 27710, United States of America. Tel: 919 681 3816; Fax: 919 681 7934; E-mail: jina.kim1@duke.edu
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Abstract

Background

Previous studies have identified risk factors for femoral arterial thrombosis after paediatric cardiac catheterisation, but none of them have evaluated the clinical and economic significance of this complication at the population level. Therefore, we examined the national prevalence and economic impact of femoral arterial thrombosis after cardiac catheterisation in children.

Methods

Patients⩽18 years of age who underwent cardiac catheterisation were identified in the 2003–2009 Kids’ Inpatient Database. Patients were stratified by age as follows: <1 year of age or 1–18 years of age. The primary outcome was arterial thrombosis of the lower extremity during the same hospitalisation as cardiac catheterisation. Propensity score matching was used to determine the impact of femoral arterial thrombosis on hospital length of stay, cost, and mortality.

Results

Among the 11,497 paediatric cardiac catheterisations identified, 4558 catheterisations (39.6%) were performed in children <1 year of age. This age group experienced a higher prevalence of reported femoral arterial thrombosis, compared with children aged 1–18 years (1.3 versus 0.3%, p<0.001). After matching, femoral arterial thrombosis in children <1 year of age was associated with similar mortality (5.4 versus 1.8%, p=0.28), length of stay (8 versus 5 days, p=0.11), and total hospital cost ($27,135 versus $28,311, p=0.61), compared with absence of thrombosis.

Conclusions

Femoral arterial thrombosis is especially prevalent in children <1 year of age undergoing cardiac catheterisation. Clinicians should be vigilant in monitoring femoral arterial patency in neonates and infants after cardiac catheterisation.

Keywords

femoral arteryCHDcardiac catheterisationchild
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 912 - 917
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Copyright
© Cambridge University Press 2016 

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