Do infants with transposition of the great arteries born outside a specialist centre have different outcomes?

Veal, Colin; Hunt, Richard; Tume, Lyvonne N.

Abstract

© Cambridge University Press 2019. Background: Infants born with undiagnosed transposition of the great arteries continue to be born in district general hospitals despite the improvements made in antenatal scanning. Evidence indicates improved outcomes with early definitive treatment after birth, hence the recommendation of delivery in a tertiary centre. The role of specialist paediatric and neonatal transport teams, to advise, stabilise, and transport the infants to a tertiary centre in a timely manner, is critical for those infants born in a district general hospital. This pilot study aims to compare outcomes between infants born in district general hospitals and those who were born in a tertiary maternity unit in South West England and South Wales.Methods: This was a secondary data analysis of data collected from the local Paediatric Intensive Care Audit Network and the local transport database. Infants born with a confirmed diagnosis of transposition of the great arteries, that required an arterial switch operation as the definitive procedure between April, 2012 and March 2018 were included.Results: Forty-five infants with a confirmed diagnosis of transposition of the great arteries were included. Statistical analysis demonstrated there were no significant differences in the time to balloon atrial septostomy (p = 0.095), time to arterial switch operation (p = 0.461), length of paediatric ICU stay (p = 0.353), and hospital stay (p = 0.095) or mortality between the two groups.Conclusions: We found no significant differences in outcomes between infants delivered outside the specialist centre, who were transferred in by a specialist team.

Citation

Veal, C., Hunt, R., & Tume, L. N. (2019). Do infants with transposition of the great arteries born outside a specialist centre have different outcomes?. Cardiology in the Young, 29(8), 1030-1035. https://doi.org/10.1017/S1047951119001367

• Journal Article Type: Article
• Acceptance Date: May 16, 2019
• Online Publication Date: Jul 5, 2019
• Publication Date: Aug 1, 2019
• Deposit Date: May 24, 2019
• Publicly Available Date: Jan 6, 2020
• Journal: Cardiology in the Young
• Print ISSN: 1047-9511
• Electronic ISSN: 1467-1107
• Publisher: Cambridge University Press (CUP)
• Peer Reviewed: Peer Reviewed
• Volume: 29
• Issue: 8
• Pages: 1030-1035
• DOI: https://doi.org/10.1017/S1047951119001367
• Keywords: paediatric, neonatal, newborn, Balloon Atrial Septostomy, specialist retrieval, transport; Arterial Switch Operation
• Public URL: https://uwe-repository.worktribe.com/output/846887