Cardiology in the Young

Original Articles

Comparative risk of cardiac catheterisations performed on low birth weight neonates

Meghan M. Mobleya1 c1, Richard E. Stroupa2 and Stephen F. Kainea3

a1 Department of Pediatrics, Graduate Medical Education Office, Children's Mercy Hospital, Kansas City, Missouri, United States of America

a2 Department of Pediatric Cardiology & Cardiovascular Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States of America

a3 Department of Pediatric Cardiology, Children's Mercy Hospital, Kansas City, Missouri, United States of America

Abstract

To determine whether cardiac catheterisation procedures for low birth weight neonates ≤2.5 kg carries a greater risk of complications compared with neonates >2.5 kg, we conducted a single-centre retrospective case–control study. From 01/03 to 01/09, 46 consecutive neonates <2.5 kg at the time of cardiac catheterisation were identified. For each low birth weight case, three control patients >2.5 kg were randomly selected from our heart centre database during the same time period. Data included demographic characteristics, type of intervention, fluoroscopy time, contrast volume, pre- and post-blood urea nitrogen to creatinine ratio, physician performing procedure, procedural risk category, and all major and minor complications. The overall incidence of complications was higher in neonates ≤2.5 kg compared with neonates >2.5 kg (34.8% versus 17.6%, p = 0.023) because of a greater proportion of minor complications (34.8% versus 16.9%, p = 0.021). When specific minor complications were stratified, there was a greater incidence of hypotension requiring intravenous fluids in neonates ≤2.5 kg (6.5% versus 0%, p = 0.015). After controlling for physician performing procedure and risk category, neonates ≤2.5 kg remained at a higher risk for any complication (adjusted odds ratio = 3.2, 95% confidence interval 1.4–7.2, p = 0.005). The percentage of neonates having at least one major complication was not higher in the ≤2.5-kg group (2.2% versus 2.2%). No procedural deaths occurred in either group.

(Received August 25 2012)

(Accepted November 19 2012)

(Online publication February 07 2013)

Keywords

  • Outcomes;
  • complications;
  • procedure-type risk categories

Correspondence

c1 Correspondence to: Dr Meghan M. Mobley, MD, Department of Pediatrics, Graduate Medical Education Office, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, Missouri 64108, United States of America. Tel: +1(816) 234-3371; Fax: +816-234-3701; E-mail: mmobley@cmh.edu