Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .
Length of stay after infant heart surgery is related to cognitive outcome at age 8 years.
OBJECTIVE To test the hypothesis that postoperative length of stay ( LOS ) after infant heart surgery  might be an easily measured surrogate marker for various events that culminate in later adverse cognitive outcome . METHODS Among 160 eligible patients with D-transposition of the great arteries undergoing reparative surgery in infancy , 155 ( 97 % ) were reevaluated at age 8 years with IQ and achievement testing . We explored whether LOS quartiles were associated with these outcomes when adjusting for perioperative and sociodemographic variables . RESULTS Longer cardiac intensive care unit ( CICU ) LOS quartiles were associated at age 8 years with lower full-scale IQ ( P=.02 ) , lower verbal IQ ( P=.02 ) , and with tendencies toward lower performance IQ ( P=.08 ) and math achievement ( P=.08 ) in adjusted models . Compared with patients in the first quartile of CICU LOS , those in the fourth quartile had mean scores for full-scale IQ that were lower by 7.2 points ( P=.01 ) ; verbal IQ , 7.3 points ( P=.02 ) ; performance IQ , 5.8 points ( P=.05 ) ; and math achievement , 6.0 points ( P=.07 ) . Analyses on hospital LOS quartile were similar . CONCLUSIONS Longer postoperative LOS is associated with worse later cognitive function , even when adjusted for perioperative events , perfusion times , and sociodemographic variables . Further research is necessary to determine the mechanisms underlying this relation
Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .