Utility of competing risks in analyzing outcomes of repair of congenital heart defects.
Published: 2005
Language: eng
Number of pages: 101
Description: Background and objectives. Congenital heart disease outcomes analysis often involves competing endpoints. Generation of clinically relevant competing risks (CR) models providing therapeutic inferences is demonstrated.For ACHD, CR defined prevalence of hospital mortality (4.5%) and discharge (95.5%). Single CR model simultaneously analyzed mortality and LOS and illustrated risk factor impact on early outcomes.Methods. CR methodology was used to quantify cumulative incidence and risk factors for: (1) death and definitive repair states in 408 neonates with pulmonary atresia-intact ventricular septum (PAIVS); (2) hospital mortality and discharge in 1351 adult congenital cardiac operations (ACHD).Conclusions. CR is useful in analyzing outcomes after congenital heart surgery. Clinically relevant multivariable models demonstrating the impact of important risk factors on outcomes can be generated.Results. In PAIVS, CR prevalence of 15-year end-states were: 2-ventricle repair, 33%; Fontan, 20%; pre-repair death, 38%; other, 9%. Morphologically-driven institutional protocols mitigate impact of unfavorable morphology.
Notes: Source: Masters Abstracts International, Volume: 44-01, page: 0309.

Thesis (M.Sc.)--University of Toronto, 2005.

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