Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

BackgroundPatients with congenital heart disease are at risk of motor, cognitive, speech, and feeding difficulties after cardiac surgery. Rehabilitation therapy could improve functional outcomes in this population if applied in the acute postcardiac surgical in‐hospital stay. However, information on...

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Autores principales:	Ana Ubeda Tikkanen, Meena Nathan, Lynn A. Sleeper, Marisa Flavin, Ana Lewis, Donna Nimec, John E. Mayer, Pedro del Nido
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2018
Materias:	congenital heart disease function pediatrics rehabilitation surgery Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/67e2f7c459e342c1b00ae1b33376214a
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spelling	oai:doaj.org-article:67e2f7c459e342c1b00ae1b33376214a2021-11-12T17:01:56ZPredictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery10.1161/JAHA.117.0080942047-9980https://doaj.org/article/67e2f7c459e342c1b00ae1b33376214a2018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.117.008094https://doaj.org/toc/2047-9980BackgroundPatients with congenital heart disease are at risk of motor, cognitive, speech, and feeding difficulties after cardiac surgery. Rehabilitation therapy could improve functional outcomes in this population if applied in the acute postcardiac surgical in‐hospital stay. However, information on the types of acute postcardiac surgery therapy needs in children is scarce. Our goal was to describe rehabilitation therapy following congenital heart surgery and pre/intraoperative factors associated with need for therapy. Methods and ResultsThis is a retrospective cohort study of patients <18 years undergoing heart surgery at our center from January 1, 2013 to January 31, 2015. Demographic, and pre‐, intra‐, and postoperative clinical and rehabilitation therapy (physical, occupational, speech, feeding therapy, and neurodevelopment intervention) data were collected. Need for rehabilitation therapy in the acute postoperative period, particularly following palliative repair, was the outcome variable in a multivariable logistic regression model to identify independent pre‐ and intraoperative factors associated with therapy. A total of 586 out of 1415 (41%) subjects received rehabilitation therapy postsurgery. Certain subgroups had increased rehabilitation therapy use such as neonates (80%). On multivariable analysis, palliative repair, prematurity, genetic syndrome, presurgical hospital stay of more than 1 day, and prolonged cardiopulmonary bypass time were independently associated with rehabilitation therapy. ConclusionsNearly half of patients who underwent post–congenital heart surgery received rehabilitation therapy. Frequency of use and types of therapy vary according to patient characteristics; however, certain pre‐ and intraoperative factors are associated with need for rehabilitation therapy, and may aid decision‐making for appropriate resource allocation.Ana Ubeda TikkanenMeena NathanLynn A. SleeperMarisa FlavinAna LewisDonna NimecJohn E. MayerPedro del NidoWileyarticlecongenital heart diseasefunctionpediatricsrehabilitationsurgeryDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	congenital heart disease function pediatrics rehabilitation surgery Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	congenital heart disease function pediatrics rehabilitation surgery Diseases of the circulatory (Cardiovascular) system RC666-701 Ana Ubeda Tikkanen Meena Nathan Lynn A. Sleeper Marisa Flavin Ana Lewis Donna Nimec John E. Mayer Pedro del Nido Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery
description	BackgroundPatients with congenital heart disease are at risk of motor, cognitive, speech, and feeding difficulties after cardiac surgery. Rehabilitation therapy could improve functional outcomes in this population if applied in the acute postcardiac surgical in‐hospital stay. However, information on the types of acute postcardiac surgery therapy needs in children is scarce. Our goal was to describe rehabilitation therapy following congenital heart surgery and pre/intraoperative factors associated with need for therapy. Methods and ResultsThis is a retrospective cohort study of patients <18 years undergoing heart surgery at our center from January 1, 2013 to January 31, 2015. Demographic, and pre‐, intra‐, and postoperative clinical and rehabilitation therapy (physical, occupational, speech, feeding therapy, and neurodevelopment intervention) data were collected. Need for rehabilitation therapy in the acute postoperative period, particularly following palliative repair, was the outcome variable in a multivariable logistic regression model to identify independent pre‐ and intraoperative factors associated with therapy. A total of 586 out of 1415 (41%) subjects received rehabilitation therapy postsurgery. Certain subgroups had increased rehabilitation therapy use such as neonates (80%). On multivariable analysis, palliative repair, prematurity, genetic syndrome, presurgical hospital stay of more than 1 day, and prolonged cardiopulmonary bypass time were independently associated with rehabilitation therapy. ConclusionsNearly half of patients who underwent post–congenital heart surgery received rehabilitation therapy. Frequency of use and types of therapy vary according to patient characteristics; however, certain pre‐ and intraoperative factors are associated with need for rehabilitation therapy, and may aid decision‐making for appropriate resource allocation.
format	article
author	Ana Ubeda Tikkanen Meena Nathan Lynn A. Sleeper Marisa Flavin Ana Lewis Donna Nimec John E. Mayer Pedro del Nido
author_facet	Ana Ubeda Tikkanen Meena Nathan Lynn A. Sleeper Marisa Flavin Ana Lewis Donna Nimec John E. Mayer Pedro del Nido
author_sort	Ana Ubeda Tikkanen
title	Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery
title_short	Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery
title_full	Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery
title_fullStr	Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery
title_full_unstemmed	Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery
title_sort	predictors of postoperative rehabilitation therapy following congenital heart surgery
publisher	Wiley
publishDate	2018
url	https://doaj.org/article/67e2f7c459e342c1b00ae1b33376214a
work_keys_str_mv	AT anaubedatikkanen predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery AT meenanathan predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery AT lynnasleeper predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery AT marisaflavin predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery AT analewis predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery AT donnanimec predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery AT johnemayer predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery AT pedrodelnido predictorsofpostoperativerehabilitationtherapyfollowingcongenitalheartsurgery
_version_	1718430373922209792

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

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