Assuntos
Bases de Dados Factuais , Cardiopatias Congênitas , Sociedades Médicas , Cirurgia Torácica , Humanos , Cardiopatias Congênitas/cirurgia , Sociedades Médicas/tendências , Cirurgia Torácica/tendências , Bases de Dados Factuais/tendências , Cirurgiões/tendências , Procedimentos Cirúrgicos Cardíacos/métodos , Procedimentos Cirúrgicos Cardíacos/tendências , Pesquisa Biomédica/tendências , Pesquisa Biomédica/métodos , Procedimentos Cirúrgicos Torácicos/tendências , Procedimentos Cirúrgicos Torácicos/métodosAssuntos
Humanos , Coração/anatomia & histologia , Coração/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos/tendências , Ecocardiografia/métodos , Fluoroscopia/instrumentação , Espectroscopia de Ressonância Magnética/métodos , Ecocardiografia Transesofagiana/métodos , Imagem Multimodal/métodosRESUMO
OBJECTIVE: To evaluate the trends in hospitalizations for children with trisomy 18 over time and to determine the rate of invasive procedures on these children, using a large inpatient database. STUDY DESIGN: A retrospective analysis using the Kids' Inpatient Database from 1997 to 2016 was performed for trisomy 18. We evaluated survival to discharge as well as the presence of pulmonary, skeletal, neurologic, gastrointestinal, renal, and hematologic/bleeding problems. We also searched for the following interventions, if performed: gastrostomy tube placement, tracheostomy, or cardiac procedure. RESULTS: Over this period 10 151 admissions occurred in children with a diagnosis of trisomy 18. Between 1997 and 2016, the number of children admitted annually with trisomy 18 increased 74% from 1036 to 1798. The proportion of patients born prematurely remained stable at 14%-16% throughout the study. Gastrostomy tube placement increased 12-fold during the study period, tracheostomy increased 11-fold, and cardiac intervention increased 5-fold. The overall mortality rate decreased in those with trisomy 18 from 32% in 1997 to 21% in 2016. CONCLUSIONS: We highlight a decreased inpatient mortality rate during the study period. The number of children undergoing interventions such as gastrostomy tube and tracheostomy increased, as did the number of children undergoing cardiac intervention. Although the number of procedures has increased with the mortality rate decreasing, it is unclear at present whether the 2 are related.
Assuntos
Procedimentos Cirúrgicos Cardíacos/tendências , Gastrostomia/tendências , Hospitalização/tendências , Padrões de Prática Médica/tendências , Traqueostomia/tendências , Síndrome da Trissomía do Cromossomo 18/cirurgia , Adolescente , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Síndrome da Trissomía do Cromossomo 18/complicações , Síndrome da Trissomía do Cromossomo 18/mortalidade , Estados UnidosRESUMO
El cateterismo cardíaco en niños ha mostrado un avance significativo en las últimas décadas, transformándose de un procedimiento casi exclusivamente diagnóstico en sus inicios a un método predominantemente terapéutico en la actualidad. Para ello han contribuido la aparición de múltiples tecnologías de imágenes, así como el creciente desarrollo de materiales de muy bajo perfil y gran versatilidad que permiten el empleo de dispositivos cada vez más específicos para tratar adecuadamente un sinnúmero de enfermedades cardíacas con gran eficacia y seguridad. Esta tendencia continúa creciendo día a día, con la ayuda de nuevas modalidades de tratamiento híbrido donde cardiólogos intervencionistas y cirujanos cardiovasculares interactúan para ayudarse mutuamente, de manera tal de resolver los problemas existentes o aquellos que se van generando con el correr de los años y que afectan la vida de nuestros pacientes. Existen aún como es lógico controversias en algunos casos especiales, que se irán resolviendo paulatinamente en base a la evidencia reunida con las diferentes terapéuticas médicas utilizadas para mejorar el presente y futuro de los niños con cardiopatías (AU)
Cardiac catheterization in children has shown significant progress in recent decades, transforming from an initially almost exclusively diagnostic procedure to a predominantly therapeutic method today. The emergence of multiple imaging technologies has contributed to this progress, as has the growing development of very low-profile and highly versatile materials that allow the use of increasingly specific devices to adequately treat different types of heart disease with great efficacy and safety. This trend continues to grow day by day, with the help of new hybrid treatment modalities where interventional cardiologists and cardiovascular surgeons interact with mutual support, in order to solve existing problems or those that are generated over the years affecting the lives of our patients. Obviously, there are still controversies in specific cases, which will gradually be resolved based on the evidence that becomes available with the use of different medical therapies used to improve the present and future of children with heart disease.(AU)