scholarly journals Association Between Implementation Of Novel Therapies And Improved Survival In Patients Starting Hemodialysis: The Swedish Renal Registry 2006-2015

2020 ◽  
Author(s):  
Marie Evans ◽  
Hong Xu ◽  
Helena Rydell ◽  
Karl-Göran Prütz ◽  
Bengt Lindholm ◽  
...  
Keyword(s):  
General Population ◽  
Cox Regression ◽  
Survival Rates ◽  
Hemodialysis Patients ◽  
Phosphate Binders ◽  
Short Term ◽  
Ultrafiltration Rate ◽  
Risk Of Death ◽  
Major Cardiovascular Events ◽  
Laboratory Biomarkers

Abstract Background The recent years have witnessed significant therapeutic advances for patients on hemodialysis. We evaluated temporal changes in treatments practices and survival rates among incident hemodialysis patients. Methods Observational study of patients initiating hemodialysis in Sweden 2006-2015. Trends of hemodialysis-related practices, medications, and routine laboratory biomarkers were evaluated. The incidence of death and major cardiovascular events (MACE) across calendar years were compared against the age-sex-matched general population. Via Cox regression, we explored whether adjustment for implementation of therapeutic advances modified observed survival and MACE risks. Results Among 6,612 patients, age and sex were similar, but the burden of co-morbidities increased over time. The proportion of patients receiving treatment by hemodiafiltration, >3 sessions/week, lower ultrafiltration rate, and working fistulas increased progressively, as did use of non-calcium phosphate binders, cinacalcet, and vitamin D3. The standardized 1-year mortality decreased from 13.2% in 2006/07 to 11.1% in 2014/15. The risk of death decreased by 6% (HR 0.94, 95% CI 0.90-0.99) every two years, and the risk of MACE by 4% (HR 0.96; 0.92-1.00). Adjustment for changes in treatment characteristics abrogated these associations (HR 1.00; 0.92-1.09 for death and 1.00; 0.94-1.06 for MACE). Compared with the general population, the risk of death declined from 6 times higher 2006/2007 [standardized incidence rate ratio, sIRR 6.0 (5.3–6.9)], to 5.6 higher 2014/15 [sIRR 5.57 (4.8–6.4)]. Conclusions Gradual implementation of therapeutic advances over the last decade was associated with a parallel reduction in short-term risk of death and MACE among hemodialysis patients.

scholarly journals Usefulness of an Upright T-Wave in Lead aVR for Predicting the Short-Term Prognosis of Incident Hemodialysis Patients: A Potential Tool for Screening High-Risk Hemodialysis Patients

2015 ◽  
Vol 5 (4) ◽  
pp. 267-277 ◽  
Author(s):  
Ai Matsukane ◽  
Toshihide Hayashi ◽  
Yuri Tanaka ◽  
Masaki Iwasaki ◽  
Shun Kubo ◽  
...  
Keyword(s):  
High Risk ◽  
Cox Regression ◽  
Survival Rates ◽  
Predictive Ability ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Short Term ◽  
Cox Regression Analysis ◽  
T Wave ◽  
Lead Avr

Background/Aims: An upright T-wave in lead aVR (aVRT) has recently been reported to be associated with cardiovascular death and mortality among the general population and patients with prior cardiovascular disease (CVD). However, evidence for the predictive ability of aVRT in patients with chronic kidney disease is lacking. Therefore, a hospital-based, prospective, cohort study was conducted to evaluate the predictive ability of an upright aVRT for the short-term prognosis in incident hemodialysis patients. Methods: Among 208 patients who started maintenance hemodialysis, 79 with preexisting CVD (CVD cohort) and 129 with no history of CVD (non-CVD cohort), were studied. An upright and non-upright aVRT were defined as a wave with a positive deflection in amplitude of ≥0 mV and a negative deflection in amplitude of <0 mV, respectively. The endpoint was all-cause death. Results: Overall, the prevalence of an upright aVRT was 22.6% at baseline. During the mean follow-up period of 2.1 ± 1.0 years, 33 deaths occurred. Cumulative survival rates at 3 years after starting dialysis in patients with an upright and non-upright aVRT were 50.0 and 80.7%, respectively, in the CVD cohort and 92.0 and 91.3%, respectively, in the non-CVD cohort. In the CVD cohort, multivariate Cox regression analysis showed that an upright aVRT was an independent predictor of death after adjusting for confounding variables. Conclusion: Among Japanese hemodialysis patients at high risk for CVD, an upright aVRT seems to be useful for predicting death.

scholarly journals Short Term Outcomes of Gastric Cancer at University Teaching Hospital of Kigali (CHUK), Rwanda.

2020 ◽  
Author(s):  
Irénée Niyongombwa ◽  
Irénée David Karenzi ◽  
Isaie Sibomana ◽  
Vital Muvunyi ◽  
Jean Marie Vianney Kagimbangabo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Cox Regression ◽  
Advanced Disease ◽  
Survival Rates ◽  
University Teaching ◽  
Short Term ◽  
The Mean

Abstract Background: Gastric cancer is the 4th most common cause of cancer death worldwide with an annual global incidence of 985,600; two thirds of them being in the developing countries. Gastric cancer is endemic in the so called stomach cancer region comprising Rwanda, Burundi, South Western Uganda and eastern Kivu province of Democratic Republic of Congo and its incidence in Rwanda is estimated around 13 to 15 per 100,000 population. To date, the outcomes of gastric cancer in the East African region are under investigated, and the survival rate in Rwanda is not known. The aim of this study was to describe the short term outcomes (in-hospital mortality rate, length of hospital stay, 3, 6, 12 and 24 months survival rates) in patients treated for gastric cancer at CHUK.Methods: We retrospectively reviewed the data collected from records of patients who consulted CHUK over a period of 10 years from September 2007 to August 2016. Patients were followed in hospital and after discharge for survival length. Descriptive statistics were used for baseline demographic data, Kaplan-Meier model and univariate cox regression were used for survival analysis.Results: Of the 199 patients enrolled in the study, 92 (46%) were males and 107 (54%) females. The mean age was 55.4 ranging between 24 and 93. The mean symptoms duration was 15 months. Most patients consulted with advanced disease, 62.3% with distant metastases. Treatment with curative intent was offered for only 19.9% of patients. The in-hospital mortality rate was 13.3%. The 3, 6, 12 and 24 months survival rate was 52%, 40.5%, 28% and 23.4% respectively. The Overall survival rate was 7 months.Conclusion: Patients with gastric cancer have delayed consultations and advanced disease at the time of presentation. This cancer is associated with poor outcomes in terms of hospital mortality and post discharge survival rates.

scholarly journals Siblings of patients with rheumatoid arthritis have an increased mortality rate: a Swedish cohort study

RMD Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e001197
Author(s):  
Helga Westerlind ◽  
Bénédicte Delcoigne ◽  
Johan Askling
Keyword(s):  
Rheumatoid Arthritis ◽  
General Population ◽  
Excess Mortality ◽  
Cox Regression ◽  
Direct Impact ◽  
Risk Of Death ◽  
Increased Risk ◽  
Patient Groups ◽  
Swedish Cohort ◽  
New Onset

ObjectivesTo estimate the mortality among siblings of patients with rheumatoid arthritis (RA) and put any excess mortality among these in relation to the mortality among patients with RA.MethodsUsing prospective nation-wide registers, we identified patients diagnosed with new-onset RA 2001–2017 (n=8137), patients with prevalent RA 2006–2017 (n=25 464), matched general population comparator subjects to all RA patients (n=22 457/68 674) and full-siblings of all groups (n=28 878/91 546).We followed all cohorts until death, 31 December 2018, migration and (for non-RA subjects) RA diagnosis. We compared patients with RA versus the general population, and siblings of RA versus siblings of the general population using Cox regression, including adjustment for socio-economy.ResultsThe HR of death versus the general population was 1.11 (95% CI 1.01 to 1.22) for incident and 1.46 (95% CI 1.39 to 1.52) for prevalent patients with RA. The siblings of these patient groups were also at increased risk of death (HR=1.10, 95% CI 1.01 to 1.20 and 1.09, 95% CI 1.04 to 1.13, respectively), with little impact of adjustment for socio-economy.ConclusionThe mortality in RA is increased, but around one-fifth of this excess is present also among their siblings. Previous literature using general population rates for comparison has thus likely overestimated the direct impact on mortality attributable to RA. To bring down excess mortality in RA, optimal disease control is important but may not suffice.

Differences in Survival Rates for Patients with Hodgkin Lymphoma, Who Were Treated Inside vs. Outside Therapy Optimisation Protocols in Germany.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2321-2321
Author(s):  
Corinne Brillant ◽  
Claudia Terschueren ◽  
Sylke Gierer ◽  
Jeremy Franklin ◽  
Stephanie Heidelbach ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Regression Analysis ◽  
Hodgkin Lymphoma ◽  
Cox Regression ◽  
Survival Rates ◽  
Observation Time ◽  
Advanced Stage ◽  
Exclusion Criteria ◽  
Cox Regression Analysis ◽  
Risk Of Death

Abstract Introduction: Despite the improvements and knowledge brought by clinical trials to cancer treatment, it remained unclear how beneficial participation in a clinical trial with Therapy Optimisation Protocol (TOP) is for patients (pts) with Hodgkin Lymphoma (HL) in relation to pts treated outside of trials. In the TOPiCS project, trial participants (TOP) were compared with non-trial pts (non-TOP). Methods: In the population-based survey NLL, which aimed to register all incident HL-cases 356 pts were recorded in six counties of northern Germany with a first diagnosis of HL in 1988–1998. Data on staging, therapy, adverse events and survival were collected. The dataset was additionally screened for patients fulfilling inclusion and exclusion criteria for clinical trials of the German Hodgkin Study Group (GHSG). A total of 328 pts were documented of whom 198 pts (60%) met the inclusion criteria of the GHSG. Of these, 125 pts (63%) have not been recruited into GHSG trials (non-TOP pts). They were compared retrospectively with 4963 TOP pts randomised nation-wide between 1988–1998 in the GHSG trials HD4-HD9. Endpoints were Overall Survival (OS) and Progression Free Survival (PFS) which considered progression, relapse and death of any cause as events. Survival analysis was performed using Kaplan-Meier method and log-rank tests. Cox regression analysis was used for multivariable modelling of risk of death or progression and included 118 non-TOP pts and 4958 TOP pts. Results: The demographic parameters were not well balanced between the two groups: TOP pts were younger, had more often advanced stage and diagnosis in the later study generation than the non-TOP pts. The median observation time for OS was 7 yrs for the TOP group and 10 yrs for the non-TOP group. The 5-yrs OS for TOP pts is 89% (95%–CI [88–90]) and for non-TOP 89% (95%-CI [82–94])(p=0.63). The 5-year PFS for TOP pts is 79% (95%–CI [78–80]) and for non-TOP pts 68% (95%–CI [59–76])(p&lt;0.001). According to Cox-regression analysis, 5 parameters were significantly (p&lt;0.01) associated with poor OS and PFS: male sex, older age, advanced stage (according to DHSG classification considering Ann Arbor stage, B-symptoms and risk factors) and earlier study generation. Participation in a TOP-trial did not contribute independently for OS (Hazard Ratio (HR)=1.12, 95%–CI [0.71–1.79]) but contributed independently and positively for PFS (HR=0.66, 95%–CI [0.49–0.89]). The difference is mainly due to a higher number of relapses. Conclusion: For German patients fulfilling inclusion and exclusion criteria for TOP, a participation in therapy optimisation protocols results in a higher PFS, allowing for the influence of other factors, than for patients who were treated outside of TOP-trials. However, no difference was observed in OS.

Conditional Survival and Cause-Specific Mortality in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation (alloHCT) for Hematologic Malignancy Over Three Decades

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 606-606
Author(s):  
Saro H. Armenian ◽  
Can-Lan Sun ◽  
Tabitha Vase ◽  
George Mills ◽  
Liezl Atencio ◽  
...  
Keyword(s):  
General Population ◽  
Hematologic Malignancy ◽  
Survival Rates ◽  
Mortality Rates ◽  
Conditional Survival ◽  
Risk Of Death ◽  
Increased Risk ◽  
Risk Of Relapse ◽  
Treatment Related Mortality ◽  
Related Mortality

Abstract Abstract 606 Background: alloHCT is offered with curative intent to patients with hematologic malignancies, and conventionally-computed survival estimates are offered for prognosticating outcomes. However, conventionally-computed survival estimates do not take into account elapsed time (and changing hazards with time survived); conditional survival overcomes these limitations, by calculating the probability of survival after having already survived a certain period of time – such data are unavailable for alloHCT recipients. We describe cause-specific (relapse-, GvHD-, treatment-related) conditional survival after alloHCT, providing clinically relevant information for patients who have survived 6 mos, 1, 2, and 5y after alloHCT. Methods: From 1976 to 2006, 2,427 consecutive patients received alloHCT for a hematologic malignancy at a single institution (median age: 34.7y [0.6–72.5]). Vital status and cause of death were determined using National Death Index, Social Security Death Index and medical records. Results: As of 12/31/2007, a total of 1413 deaths (58% of the cohort) were observed; 39% attributed to recurrent disease; 34% to GvHD; 12% to infection; 5% to cardiopulmonary disease; 2% to subsequent malignant neoplasm (SMNs); and 8% to other causes. Conventionally-computed probability of survival was 44.6% at 5y and 41.2% at 10y from alloHCT. On the other hand, conditional on survival for 6 mo, 1, 2, and 5y after alloHCT, 5-y survival rates were 62%, 75%, 83%, and 93%, respectively (Figure A). The cohort was at a 40-fold increased risk of any death compared with the general population (95%CI=38.2–42.4); at a 25.6-fold increased risk of death due to pulmonary complications, 3.3-fold risk due to SMNs, and 2.3-fold risk due to cardiovascular complications. Among patients followed for 15+y after HCT, the risk of all-cause mortality was 2.6-fold that of the general population (95%CI=1.8–3.7). Standardized mortality ratios (SMR) and cause-specific conditional mortality rates by primary diagnosis are summarized in the Table. Individuals who survived the first 5y had negligible (≤5%) risk of relapse- and GvHD-related mortality over the subsequent 5y. Treatment-related mortality increased over time; among those who survived 5y, treatment-related mortality rates exceeded relapse-related mortality (Figure B). After adjustment for demographics, underlying diagnosis and treatment era, individuals with chronic GVHD (cGVHD) had a significantly lower risk of relapse-related mortality (RR=0.43, 95%CI=0.4–0.5) compared to those without cGVHD. Conclusions: The projected 5-y survival rates improve conditional on time survived from alloHCT; 5-y survival exceeds 93% for those who have already survived 5y. However, alloHCT recipients who have survived 15+y continue to remain at increased risk of death compared to the general population. cGVHD is associated with decreased risk of relapse-related mortality. Both relapse-related and GvHD-related mortality rates decline with time, such that, among those who have survived 5y, treatment-related mortality exceeds relapse-related mortality. Conditional survival estimates provide clinically relevant prognostic information, helping inform preventive and interventional strategies. Disclosures: No relevant conflicts of interest to declare.

scholarly journals EGFR and KRAS Mutations in the Non-Tumoral Lung. Prognosis in Patients with Adenocarcinoma

2019 ◽  
Vol 8 (4) ◽  
pp. 529 ◽  
Author(s):  
Roberto Chalela ◽  
Beatriz Bellosillo ◽  
Víctor Curull ◽  
Raquel Longarón ◽  
Sergi Pascual-Guardia ◽  
...  
Keyword(s):  
Cox Regression ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Lung Parenchyma ◽  
Normal Lung ◽  
Short Term ◽  
Kras Mutations ◽  
Genetic Changes ◽  
Risk Of Progression

Tumor recurrence is frequent and survival rates remain extremely low in lung adenocarcinoma (ADC). We hypothesize that carcinogenic factors will promote loco-regional modifications not only in the future tumor, but throughout the exposed lung. Objective: To analyze whether the most prevalent mutations observed in ADC can also be observed in the non-neoplastic lung tissue, as well as the short-term prognosis implications of this finding. Methods: Non-tumoral lung parenchyma specimens obtained during surgery from 47 patients with EGFR and/or KRAS abnormalities in their ADC tumors underwent similar genomic testing. Short-term outcomes were also recorded. Results: The same mutations were present in the tumor and the histologically normal tissue in 21.3% of patients (SM group). Although local recurrences were similar in both groups, distant metastases were more frequent in the former (60 vs. 5.4%, p < 0.001). Moreover, SM patients showed lower time-to-progression (8.5 vs. 11.7 months, p < 0.001) and disease-free survival (8.5 vs. 11.2 months, p < 0.001). COX regression showed a higher risk of progression or death (DFS) in the SM group (HR 5.94, p < 0.01]. Similar results were observed when adjusting for potential confounding variables. Conclusions: These results confirm that genetic changes are present in the apparently normal lung in many ADC patients, and this finding has prognostic implications.

scholarly journals P1437RELATIONS BETWEEN IMPLEMENTATIONS OF EVIDENCE-BASED TREATMENTS AND IMPROVED OUTCOMES IN PATIENTS STARTING HEMODIALYSIS DURING THE LAST 10 YEARS: EXPERIENCES FROM THE SWEDISH RENAL REGISTRY 2006-2015

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marie Evans ◽  
Hong Xu ◽  
Maria Stendahl ◽  
Helena Rydell ◽  
Juan Jesus Carrero
Keyword(s):  
Cardiovascular Events ◽  
Regression Models ◽  
Cox Regression ◽  
Phosphate Binders ◽  
Evidence Based ◽  
Risk Of Death ◽  
Evidence Based Treatments ◽  
One Year ◽  
The One ◽  
Over Time

Abstract Background and Aims Although few randomized controlled trials have been able to demonstrate benefits of single treatments in improving outcomes of patients undergoing hemodialysis (HD), the last decades have witnessed significant therapeutic advances. This relates both to the HD treatment itself and to the management of patient complications. We here evaluated temporal changes in the use of evidence-based treatments and survival rates in incident HD patients. Method We included all patients initiating HD in Sweden between 2006-2015 and followed them until the end of 2017. Data were linked to national registries to retrieve information on date of death, cardiovascular events, comorbidity, and drug prescriptions. We first evaluated trends in the use of different HD related therapies and selected key therapeutic targets and medications in 2-year blocks. We then evaluated the incidence of death and major cardiovascular events (MACE) within one and two years from start of dialysis through standardized incidence rates via logistic regression models to account for differences in patient characteristics over time. Via Cox regression models, we explored whether adjustment for implementation of evidence-based treatments (e.g. hemodiafiltration (HDF), frequent HD, working fistula, drugs to control CKD-MBD, anemia) modified the observed survival and MACE risks. Finally, survival trends were also compared against an age-sex-calendar year-matched general Swedish population using standardized incidence ratios. Results We identified 6,612 patients starting HD in Sweden during the study period. There was no difference in mean age or proportion of women over time, but body mass index, serum parathyroid hormone levels and the proportion of patients with cerebrovascular disease, atrial fibrillation and cancer increased. Conversely, mean serum hemoglobin, phosphate and albumin values decreased over time. The proportion of patients who underwent HDF, had more than three HD sessions/week, and had a working fistula increased progressively, as well as the use of phosphate binders (particularly non-calcium), cinacalcet, and vitamin D3. After standardization for differences in demography and comorbidities, the one-year risk of mortality or MACE risk decreased by 7% and 16%, respectively, in 2014/15 compared to 2006/07. Similarly, the two-year risk of death or MACE decreased by 16 and 21%. In multivariable Cox models, we explored the linear association between calendar year blocks and study outcomes. Per 2-year period, the risk of death within one year decreased by 6% (HR 0.94, 95% CI 0.92-1.00), and of MACE by 5% (0.94, 95% CI 0.92-0.98). Adjustment for changes in the evidence-based treatments over time abrogated these associations (HR 1.00, 95% CI 0.91-1.09 for death and 1.00, 95% CI 0.94-1.06 for MACE). Similar results were obtained for 2-year outcomes. Compared with the general population, the one-year risk of death for a HD patient was 6 times higher in 2006/2007 [standardized incidence rate ratio, SIR 6.05 (5.30–6.91)], but decreased to 5.5 times higher in 2014/15 [SIR 5.57 (4.82–6.44)], corresponding to a SIR reduction of 8%. Conclusion In patients initiating HD therapy in Sweden, there has been a gradual implementation of new and established evidence-based treatments during the last 10 years, which was associated with a parallel reduction in the risk of death and MACE.

scholarly journals Short Term Outcomes of Gastric Cancer at University Teaching Hospital of Kigali (CHUK), Rwanda.

2021 ◽  
Author(s):  
Irénée Niyongombwa ◽  
Irénée David Karenzi ◽  
Isaie Sibomana ◽  
Vital Muvunyi ◽  
Jean Marie Vianney Kagimbangabo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Cox Regression ◽  
Advanced Disease ◽  
Survival Rates ◽  
University Teaching ◽  
Short Term ◽  
The Mean

Abstract Purpose: Gastric cancer is endemic in the so called stomach cancer region comprising Rwanda, Burundi, South Western Uganda and eastern Kivu province of Democratic Republic of Congo but its outcomes in that region are under investigated. This is the first study ever conducted in Rwanda with the purpose to describe the short term outcomes (in-hospital mortality rate, length of hospital stay, 3, 6, 12 and 24 months survival rates) in patients treated for gastric cancer. Methods: We retrospectively reviewed the data collected from records of patients who consulted CHUK over a period of 10 years from September 2007 to August 2016. Patients were followed in hospital and after discharge for survival length. Descriptive statistics were used for baseline demographic data, Kaplan-Meier model and univariate cox regression were used for survival analysis. Results: Of the 199 patients enrolled in the study, 92 (46%) were males and 107 (54%) females. The mean age was 55.4 ranging between 24 and 93. The mean symptoms duration was 15 months. Most patients consulted with advanced disease, 62.3% with distant metastases. Treatment with curative intent was offered for only 19.9% of patients. The in-hospital mortality rate was 13.3%. The 3, 6, 12 and 24 months survival rate was 52%, 40.5%, 28% and 23.4% respectively. The Overall survival rate was 7 months. Conclusion: In Rwanda, patients with gastric cancer have delayed consultations and advanced disease at the time of presentation. This cancer is associated with poor outcomes in terms of hospital mortality and post discharge survival rates.

Analysis of outcomes in patients with abnormal laterality undergoing congenital heart surgery

2021 ◽  
pp. 1-7
Author(s):  
Serdar Basgoze ◽  
Bahar Temur ◽  
Osman Guvenc ◽  
Selim Aydin ◽  
Fusun Guzelmeric ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Cox Regression ◽  
Neonatal Period ◽  
Survival Rates ◽  
Postoperative Mortality ◽  
Kidney Injury ◽  
Congenital Heart Surgery ◽  
Right Atrial ◽  
Risk Of Death ◽  
Atrial Isomerism

Abstract Objective: Laterality anomalies are almost always associated with severe cardiac anomalies. Demographic properties, type of the procedures, associated anomalies, and early and mid-term prognosis of four types of laterality anomalies were analysed. Methods: A total of 64 consecutive patients with laterality anomalies were enrolled between July 2014 and July 2020. We grouped the patients as situs solitus dextrocardia (SSD) (n = 12; 18.7%); situs inversus (SI) (n = 16; 25%); right atrial isomerism (RAI) (n = 29; 45.3%); and left atrial isomerism (LAI) (n = 7; 10.9%). TAPVC was only present in the RAI group (31%). Incidence of mitral or tricuspid atresia was higher in the SSD group (25%). All the patients were followed up with a mean of 19.06 ± 17.6 (0.1–72) months. Results: Early postoperative mortality was 17 patients, among 107 procedures (15.8%). Twelve patients were in the neonatal period. All ten patients survived after isolated ductal stenting. Fourteen of the deaths were in the RAI group (48.3%). The 3-year survival rates were 85% in LAI, 78.7% in SI, 55.8% in SSD, and 38% in RAI groups. According to the multivariable Cox regression model, mechanical ventilation, kidney injury, RAI, and complex surgery in the neonatal period were independent risk factors for early mortality. Conclusion: Laterality anomalies are one of the most challenging patients who commonly had univentricular physiology. The most prevalent anomaly was RAI, and RAI had the worst outcome and survival. Ductal stent is an acceptable first intervention during the neonatal period in suitable patients. Complex procedures may carry a high risk of death in the neonatal period.

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