ArticleThe Annals of thoracic surgery2019
The Quest for Precision Medicine: Unmeasured Patient Factors and Mortality After Congenital Heart Surgery.
Article in The Annals of thoracic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Article
- Public Reporting and Case Selection in Congenital Heart Surgery: Signals From a Multicenter Observational Study.Journal of the American College of Cardiology · 2026Observational
- Quality Assessment in Paediatric Cardiology: Experiences from Leveraging a Clinical Data Warehouse.Life (Basel, Switzerland) · 2026Article
- Improving Risk Adjustment in the Assessment of Congenital Heart Center Surgical Quality.The Annals of thoracic surgery · 2026Article
- Higher Mortality After Cardiac Surgery is Observed in Cohort from Disadvantaged Neighborhoods.Pediatric cardiology · 2026Article
- Neonatal Depression Is Associated With 1-Year Mortality in Critical Congenital Heart Disease.Journal of the American Heart Association · 2023Article
- Trend of fetal echocardiography use and comparison of medical costs for congenital heart disease treatment based on fetal echocardiography use in a Korean single center.Frontiers in pediatrics · 2023Article
- Treatment Evolution and the Impact of Pre-Surgical Predictors on Outcomes of Patients with Congenital Heart Disease.Arquivos brasileiros de cardiologia · 2022Article
- Impact of Maternal-Fetal Environment on Mortality in Children With Single Ventricle Heart Disease.Journal of the American Heart Association · 2022Article
- A machine learning-based pulmonary venous obstruction prediction model using clinical data and CT image.International journal of computer assisted radiology and surgery · 2021Article
- Prognostic Model to Predict Postoperative Adverse Events in Pediatric Patients With Aortic Coarctation.Frontiers in cardiovascular medicine · 2021Article
- Variants of significance: medical genetics and surgical outcomes in congenital heart disease.Current opinion in pediatrics · 2020Review
- Predicting and Surviving Prolonged Critical Illness After Congenital Heart Surgery.Critical care medicine · 2020Article
- Damaging Variants in Proangiogenic Genes Impair Growth in Fetuses with Cardiac Defects.The Journal of pediatrics · 2019Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundEmerging data across many fields suggest that unique patient characteristics can impact disease manifestation and response to therapy, supporting "precision medicine" approaches and more individualized and targeted therapeutic strategies. In children undergoing congenital heart surgery, current risk models primarily focus on the population level, and their utility in understanding precise characteristics that place individual patients at risk for poor outcome remains unclear.
methodsWe analyzed index surgeries in the Pediatric Cardiac Critical Care Consortium (PC
resultsA total of 8406 operations (22 hospitals) were included. We found that only 30% of the total between-patient variation in mortality in our cohort was explained by the patient factors included in our model. Age, The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery score, and preoperative mechanical ventilation explained the greatest proportion of variation. Of the variation that remained unexplained, 95% was attributable to unmeasured patient factors. In stratified analyses, these results were consistent across patient subgroups.
conclusionsPatient factors typically included in congenital heart surgery risk models explain only a small portion of total variation in mortality. A better understanding of other underrecognized factors is critical in further defining risk profiles and in developing more individualized and tailored therapeutic strategies.
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