Cause, timing, and location of death in the Single Ventricle Reconstruction trial
Cause, timing, and location of death in the Single Ventricle Reconstruction trial
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DOI：
10.1016/j.jtcvs.2012.04.028
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发表时间：
2012-10-01
影响因子：
6
通讯作者：
Pearson, Gail D.
中科院分区：
文献类型：
--
作者：
Ohye, Richard G.;Schonbeck, Julie V.;Pearson, Gail D.
目的：单心室重建试验在15个北美中心随机选择了555名接受诺伍德手术的单右心室受试者，接受改良的Blalock-Taussig分流术或右心室-肺动脉分流术。结果表明，随机化后12个月，改良Blalock-Taussig分流术的死亡率或心脏移植率为36%，右心室-肺动脉分流术为26%，与其他出版物一致。尽管这一高死亡率，很少有人知道周围的情况下，这些deaths.Methods：有164例死亡，在12个月postrandomization。一个委员会裁定所有死亡的原因和记录的时间，地点，和其他因素为each events.Results：最常见的死因是心血管（42%），其次是不明原因（24%）和多系统器官衰竭（7%）。12个月内死亡的受试者的中位死亡年龄为1.6个月（四分位距，0.6 - 3.7个月），住院期间死亡人数最多，与诺伍德手术相关。最常见的死亡地点是在单心室重建试验医院（74%），其次是家中（13%）。有29个突然，意外死亡（18%），虽然在回顾，12个之前的前驱症状。结论：在一个单一的右心室进行分期repairs. Conclusions婴儿，大多数死亡的12个月内的程序是由于心血管原因，发生在医院，并在最初的几个月的生活。增加对这些单心室患者死亡情况的了解可能会降低高死亡率。（《胸血管外科杂志》2012; 144：907-14）
Objectives: The Single Ventricle Reconstruction trial randomized 555 subjects with a single right ventricle undergoing the Norwood procedure at 15 North American centers to receive either a modified Blalock-Taussig shunt or right ventricle-to-pulmonary artery shunt. Results demonstrated a rate of death or cardiac transplantation by 12 months postrandomization of 36% for the modified Blalock-Taussig shunt and 26% for the right ventricle-to-pulmonary artery shunt, consistent with other publications. Despite this high mortality rate, little is known about the circumstances surrounding these deaths.Methods: There were 164 deaths within 12 months postrandomization. A committee adjudicated all deaths for cause and recorded the timing, location, and other factors for each event.Results: The most common cause of death was cardiovascular (42%), followed by unknown cause (24%) and multisystem organ failure (7%). The median age at death for subjects dying during the 12 months was 1.6 months (interquartile range, 0.6 to 3.7 months), with the highest number of deaths occurring during hospitalization related to the Norwood procedure. The most common location of death was at a Single Ventricle Reconstruction trial hospital (74%), followed by home (13%). There were 29 sudden, unexpected deaths (18%), although in retrospect, 12 were preceded by a prodrome.Conclusions: In infants with a single right ventricle undergoing staged repair, the majority of deaths within 12 months of the procedure are due to cardiovascular causes, occur in a hospital, and within the first few months of life. Increased understanding of the circumstances surrounding the deaths of these single ventricle patients may reduce the high mortality rate. (J Thorac Cardiovasc Surg 2012; 144: 907-14)