Evidence map›Paper›PMID 37572784›Full record

ArticleAmerican heart journal2023

Center-level factors associated with shorter length of stay following stage 1 palliation: An analysis of the national pediatric cardiology quality improvement collaborative registry.

Henry P Foote, Dylan Thibault, Carla Dominguez Gonzalez, Garick D Hill, L Luann Minich, Douglas M Overbey, Sarah L Tallent, Kevin D Hill, Andrew W McCrary

Abstract read
In one paragraph

Article in American heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Timing of Balloon Atrial Septostomy in Hybrid Stage 1 Palliation in Hypoplastic Left Heart Syndrome.Journal of the Society for Cardiovascular Angiography & Interventions · 2025
    Article
  4. A Three Decade Analysis of Trends in Length of Stay After Liver Transplantation.Progress in transplantation (Aliso Viejo, Calif.) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Henry P FooteDivision of Pediatric Cardiology, Duke University Medical Center, Durham, NC.
Dylan ThibaultDuke Clinical Research Institute, Durham, NC.
Carla Dominguez GonzalezDuke University School of Medicine, Durham, NC.
Garick D HillDivision of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
L Luann MinichDepartment of Pediatrics, The University of Utah and Primary Children's Hospital, Salt Lake City, UT.
Douglas M OverbeyDivision of Cardiothoracic Surgery, Duke University Medical Center, Durham, NC.
Sarah L TallentDivision of Pediatric Cardiology, Duke University Medical Center, Durham, NC.
Kevin D HillDivision of Pediatric Cardiology, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC. Electronic address: kevin.hill@duke.edu.
Andrew W McCraryDivision of Pediatric Cardiology, Duke University Medical Center, Durham, NC.

Funding

Unified Program for Therapeutics in Children (UPTiC)T32HD094671 · NICHD · DUKE UNIVERSITY · PI Ian J Davis, Kanecia Obie Zimmerman · 2019 to 2026
$2.9M
1/2 CORD-CHD: Clamp OR Delay among neonates with Congenital Heart DiseaseUG3HL166794 · NHLBI · RESEARCH INST NATIONWIDE CHILDREN'S HOSP · PI BACKES, CARL, HILL, KEVIN DENNIS · 2023 to 2023
$907k
NHLBI NIH HHS UG3 HL166794NICHD NIH HHS T32 HD094671
6 · The paper itself

Abstract

backgroundStage 1 single ventricle palliation (S1P) has the longest length of stay (LOS) of all benchmark congenital heart operations. Center-level factors contributing to prolonged hospitalization are poorly defined.

methodsWe analyzed data from infants status post S1P included in the National Pediatric Cardiology Quality Improvement Collaborative Phase II registry. Our primary outcome was patient-level LOS with days alive and out of hospital before stage 2 palliation (S2P) used as a balancing measure. We compared patient and center-level characteristics across quartiles for median center LOS, and used multivariable regression to calculate center-level factors associated with LOS after adjusting for case mix.

resultsOf 2,510 infants (65 sites), 2037 (47 sites) met study criteria (61% male, 61% white, 72% hypoplastic left heart syndrome). There was wide intercenter variation in LOS (first quartile centers: median 28 days [IQR 19, 46]; fourth quartile: 62 days [35, 95], P < .001). Mortality prior to S2P did not differ across quartiles. Shorter LOS correlated with more pre-S2P days alive and out of hospital, after accounting for readmissions (correlation coefficient -0.48, P < .001). In multivariable analysis, increased use of Norwood with a right ventricle to pulmonary artery conduit (aOR 2.65 [1.1, 6.37]), shorter bypass time (aOR 0.99 per minute [0.98,1.0]), fewer additional cardiac operations (aOR 0.46 [0.22, 0.93]), and increased use of NG tubes rather than G tubes (aOR 7.03 [1.95, 25.42]) were all associated with shorter LOS centers.

conclusionsModifiable center-level practices may be targets to standardize practice and reduce overall LOS across centers.

Indexed as

Cardiac Surgical ProceduresHeart Defects, CongenitalHypoplastic Left Heart SyndromeNorwood ProceduresChildFemaleHumansInfantLength of StayMalePalliative CareQuality ImprovementRegistriesRetrospective StudiesTreatment Outcome

Identifiers

PMID37572784
PMCPMC10729415

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.