OBJECTIVES: The hybrid approach for the initial management of @entity1699 shifts the risks of major open surgery from the vulnerable neonatal period to an older age. This study determined differences between the hybrid and the standard Norwood procedures in postoperative in-hospital mortality, @entity177 , and survival to at least 2 years of age. METHODS: Data from the Pediatric Health Information System, a detailed hospital discharge database of 43 freestanding @entity1 's hospitals, were analyzed. The Pediatric Health Information System includes demographic information, diagnosis, and procedure and clinical service data. Instrumental variable regression techniques were used to estimate the predicted probability of in-hospital mortality, @entity177 , and survival to 24 months of age for @entity1 with @entity1699 who received a hybrid or Norwood procedure. The statistical models controlled for demographics and comorbid @entity2008 . RESULTS: A total of 3654 @entity1 with @entity1699 underwent intervention from 1998 to 2012. Of these, 242 underwent the hybrid approach and the remainder underwent the Norwood procedure. Instrumental variable models showed significantly reduced odds of @entity1 who underwent the hybrid approach being diagnosed with @entity177 (adjusted risk ratio [ARR], 0.48; 95% confidence interval [CI], 0.26-0.89); increased odds of surviving initial hospitalization (ARR, 1.28; 95% CI, 1.06-1.55); increased odds of survival, indicated by readmissions more than 6 months after initial hospitalization (ARR, 1.53; 95% CI, 1.05-2.22); and a decrease in length of stay by 20 days for the initial surgical hospitalization (95% CI, -27.4 to -13.9). CONCLUSIONS: The short term hospital-based outcomes and longer-term survival outcomes of the hybrid approach for @entity1699 may be better than those of the Norwood procedure.

Comparison of in-hospital and longer-term outcomes of hybrid and Norwood stage 1 palliation of XXXX .

@entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity1699 :: ('MESH:D018636', 'Disease') :: ['hypoplastic left heart syndrome'] @entity1 :: ('9606', 'Species') :: ['children', 'patients', 'infants'] @entity2008 :: ('MESH:D002869', 'Disease') :: ['chromosomal anomalies']
@entity1699 :: (MESH:D018636,Disease) :: ['hypoplastic left heart syndrome']
