scholarly journals Factors associated with a lower chance of having gaps in care in adult congenital heart disease

2021 ◽  
pp. 1-6
Author(s):  
Jong Mi Ko ◽  
Lisa R. Yanek ◽  
Ari M. Cedars
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Multivariable Logistic Regression Analysis ◽  
Study Cohort ◽  
Factors Associated ◽  
Paediatric Care ◽  
Significant Difference ◽  
Care Gaps

Abstract Background: To promote good health in patients with congenital heart disease (CHD), prevention of gaps in care is essential, as adverse prognosis is associated with care gaps. A well-organised, formal transition programme may help prevent loss to follow up after leaving paediatric care. To inform the development of a transition programme, we investigated factors associated with care gaps in adults with CHD. Methods: Between 15 October 2018 and 15 November 2019 data on patient characteristics and patient experiences with transition-related education, difficulties, and gaps in care were collected and assessed in 87 adults with CHD. Two groups (with gaps in care versus without gaps) were compared to identify informative differences using chi-squared, Fisher’s exact tests, or Wilcoxon rank-sum tests. To assess the relationship between care gaps and identified variables, factors with significant difference (p < 0.05) in bivariate analyses were employed as covariates in multivariable logistic regression analysis. Results: About half of the study cohort reported having gaps in care. In a multivariate model, patients having thorough discussion about the importance of receiving adult care in paediatric care were 70% less likely to experience gaps (odds ratio 0.303, 95% CI 0.14, 0.66). Forty-seven percent of patient-perceived barriers to transitioning originated from negative feelings associated with transfer. Conclusion: Gaps in care are highly prevalent in adults with CHD. For a transition programme to be most effective, curriculum development may need to consider the differential impact of various factors and target areas to mitigate the psychological stress associated with transfer.

Abstract 240: Hypertension Prevalence and Management Among Adult Congenital Heart Disease Patients

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Joshua R Thomas ◽  
Ricky T Munoz ◽  
Mark D Fox ◽  
Angela T Yetman
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Hypertension Prevalence ◽  
Significant Difference ◽  
Adult Congenital ◽  
The Mean

Background: Cardiovascular risk factors (CRFs) are poorly defined among the population of adults with congenital heart disease. In particular, the prevalence of pre-hypertension (pre-HTN) and hypertension (HTN) are currently unknown. Objective: To determine the prevalence of pre-HTN and HTN among adults with congenital heart disease; and to assess HTN control rates among different clinic types. Methods: A retrospective analysis of a cohort of adults with congenital heart disease (CHD) was conducted. Data regarding CHD patients' blood pressure (BP), medications, and provider specialty were analyzed. Results: The cohort consisted of 971 patients. The mean age was 30.4 years (SD = 10.4), with 51% male. Thirty-two percent had HTN (n = 304). There was no statistically significant difference in the prevalence of Pre-HTN and HTN by clinic type (i.e. specialty vs. non-specialty)( p = .225, p= .633 respectively). However, a statistically significant association exists between clinic type and HTN control rates χ 2 (1) = 3.185, p = .07 (Table 1). Those receiving care from a specialty clinic are 1.6 times more likely to have controlled HTN. Conclusions: Pre-HTN and HTN are common among adults with congenital heart disease. These CRFs are better managed in specialty clinics devoted to this population.

scholarly journals Factors Associated with Severe Lower Respiratory Tract Infection from Respiratory Syncytial Virus (RSV) in Thai Children

2021 ◽  
Vol 73 (12) ◽  
pp. 808-814
Author(s):  
Atipotsawee Tungsupreechameth ◽  
Klaita Srisingh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Logistic Model ◽  
Congenital Heart ◽  
Clinical Manifestations ◽  
Factors Associated ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Syncytial Virus

Objective: To determine the factors associated with severe ALRTI from RSV in children.Materials and Methods: A retrospective study of children aged 1-60 months were conducted from 2014 to 2018. Out of 269 patients diagnosed with RSV ALRTI, 100 children were enrolled in the study, 20 had severe RSV ALRTI, while 80 had non-severe RSV ALRTI as identified by the ReSVinet scale. A multivariable logistic model was conducted to select significant variables.Results: During the study period, 269 patients were diagnosed with RSV ALRTI. Mean age was 10.45 ± 3.53 months. Clinical manifestations of severe RSV ALRTI group had significant difference in abnormal general condition (P < 0.001), tachypnea (P < 0.001), SpO2 < 85% (P < 0.001), poor air entry in lungs (P < 0.001), and retraction (P < 0.001). The factors associated with severe RSV ALRTI group, were underlying congenital heart disease [aOR32.45; 95% CI 3.38-311.87, P = 0.003] and duration of hospital stay >5 days [aOR 19.56; 95% CI 1.81-212.05, P = 0.014].Conclusion: Factors associated with severe RSV ALRTI in children were underlying congenital heart disease andduration of hospital stay >5 days.

Galectin-3 plasma levels in adult congenital heart disease and the pressure overloaded right ventricle: reason matters

2020 ◽  
Vol 14 (13) ◽  
pp. 1197-1205
Author(s):  
Ewa Kowalik ◽  
Beata Kuśmierczyk-Droszcz ◽  
Anna Klisiewicz ◽  
Aleksandra Wróbel ◽  
Anna Lutyńska ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Clinical Status ◽  
Pressure Overload ◽  
Cross Sectional ◽  
Galectin 3 ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

Aim: To assess galectin-3 (Gal-3) levels and their relationship with clinical status and right ventricular (RV) performance in adults with RV pressure overload of various mechanisms due to congenital heart disease. Materials & methods: A cross-sectional study was conducted. Patients underwent clinical examination, blood testing and transthoracic echocardiography. Results: The study included 63 patients with congenitally corrected transposition of the great arteries, 41 patients with Eisenmenger syndrome and 20 healthy controls. Gal-3 concentrations were higher in patients compared with controls (7.83 vs 6.11 ng/ml; p = 0.002). Biomarker levels correlated with age, New York Health Association class, N-terminal probrain natriuretic peptide and RV function only in congenitally corrected transposition of the great arteries patients. Conclusion: Gal-3 profile in congenital heart disease patients and pressure-overloaded RV differs according to the cause of pressure overload.

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