Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-12-01T00:07:58.406Z Has data issue: false hasContentIssue false
  • English
  • Français

Morbidity after paediatric cardiac surgery assessed with usage of medicines: a population-based registry study

Published online by Cambridge University Press:  20 August 2010

Heta P. Nieminen ,
Heikki I. Sairanen  and
Eero V. Jokinen
Heta P. Nieminen*
Affiliation:
Department of Surgery, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
Heikki I. Sairanen
Affiliation:
Department of Surgery, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
Eero V. Jokinen
Affiliation:
Department of Cardiology, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
*
Correspondence to: H. P. Nieminen, Piippukalliontie 33, FIN – 36270 Kangasala, Finland. Tel: +358 40 8649774; Fax: +358 3 3769420; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To examine the overall morbidity of patients who underwent surgery for congenital cardiac defect during childhood.

Background

A congenital cardiac defect treated with surgery is seldom totally cured. The incidence of residua, sequelae, and comorbidity is quite high. The morbidity has not been thoroughly examined.

Methods and patients

Medication was used as an indicator of morbidity. Data from the Finnish Research Registry of Paediatric Cardiac Surgery were linked to data from the medication registry of Finland’s Social Insurance Institution. This study includes 5116 patients with a mean age of 33.5 (ranged from 14.7 to 64.8) years, who had undergone surgery for congenital cardiac defect between 1953 and 1989. The use of medicines among patients in 2004 was compared with 10232 age- and sex-matched control subjects.

Results

The overall use of medicines was frequent; 62% of patients and 53% of controls had purchased at least one prescribed medicine (risk ratio: 1.2, 95% confidence interval: 1.1–1.2). The number of patients using cardiovascular medicines (17%) and anti-thrombotic agents (5%) was higher than that of control subjects (risk ratio: 2.2 and 8.4). In addition, the patients needed medicinal care for epilepsy (3%), asthma (7%), and psychiatric diseases (10%) more often than did controls (risk ratio: 2.2, 1.5, and 1.3, respectively).

Conclusion

Patients operated on for congenital cardiac defect had more chronic diseases and used more medicines than did controls.

Keywords

Congenital cardiac defectscardiovascular medicationcomorbidityasthmaepilepsypsychiatric diseases
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 6 , December 2010 , pp. 660 - 667
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. WHO Collaborating Centre for Drug Statistics Methodology, Guidelines for ATC classification and DDD assignment. WHO Collaborating Centre for Drug Statistics Methodology, Oslo, 2004.Google Scholar
2. Nieminen, HP, Jokinen, EV, Sairanen, HI. Late results of pediatric cardiac surgery in Finland. A population-based study with 96% follow-up. Circulation 2001; 104: 570–575.CrossRefGoogle ScholarPubMed
3. Nieminen, H, Jokinen, E, Sairanen, H. Causes of late deaths after pediatric cardiac surgery: a population-based study. J Am Coll Cardiol 2007; 50: 1263–1271.CrossRefGoogle ScholarPubMed
4. Ikäheimo, P, Hartikainen, S, Tuuponen, T, Kiuttu, J, Klaukka, T. Comorbidity and medication load in adult asthmatics. Scand J Prim Health Care 2005; 23: 88–94.CrossRefGoogle ScholarPubMed
5. Reunanen, A, Kangas, T, Martikainen, J, Klaukka, T. Nationwide survey of comorbidity, use, and costs of all medications in Finnish diabetic individuals. Diabetes Care 2000; 23: 1265–1271.CrossRefGoogle ScholarPubMed
6. Massin, MM, Astadicko, I, Dessy, H. Noncardiac comorbidities of congenital heart disease in children. Acta Paediatr 2007; 96: 753–755.CrossRefGoogle ScholarPubMed
7. Saliba, Z, Butera, G, Bonnet, D, et al. . Quality of life and perceived health status in surviving adults with univentricular heart. Heart 2001; 86: 69–73.Google ScholarPubMed
8. Warnes, CA. Transposition of the great arteries. Circulation 2006; 114: 2699–2709.CrossRefGoogle ScholarPubMed
9. Gatzoulis, MA, Balaji, S, Webber, SA, et al. . Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet 2000; 356: 975–981.CrossRefGoogle ScholarPubMed
10. Høimyr, H, Christensen, TD, Emmertsen, K, et al. . Surgical repair of coarctation of the aorta: up to 40 years follow-up. Eur J Cardiothorac Surg 2007; 30: 910–916.CrossRefGoogle Scholar
11. Cohen, M, Fuster, V, Steele, PM, Driscoll, DJ, McGoon, DC. Coarctation of the aorta. Long-term follow-up and prediction of outcome after surgical correction. Circulation 1989; 80: 840–845.CrossRefGoogle ScholarPubMed
12. Legendre, A, Losay, J, Touchot-Koné, A, et al. . Coronary events after arterial switch operation for transposition of the great arteries. Circulation 2003; 108: II-186–II-190.CrossRefGoogle ScholarPubMed
13. Moussavi, S, Chatterji, S, Verdes, E, Tandon, A, Patel, V, Ustun, B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 2007; 370: 851–858.CrossRefGoogle ScholarPubMed
14. Jaakkola, JJK, Ahmed, P, Ieromnimon, A, et al. . Preterm delivery and asthma: a systematic review and meta-analysis. J Allergy Clin Immunol 2006; 118: 823–830.CrossRefGoogle ScholarPubMed
15. Groeneveld, ABJ, Jansen, EK, Verheij, J. Mechanisms of pulmonary dysfunction after on-pump and off-pump cardiac surgery: a prospective cohort study. J Cardiothorac Surg 2007; 2: 11–18.CrossRefGoogle ScholarPubMed
16. Silliman, CC, Ambruso, DR, Boshkov, LK. Transfusion-related acute lung injury. Blood 2005; 105: 2266–2273.CrossRefGoogle ScholarPubMed
17. Hövels-Gürich, HH, Seghaye, M-C, Däbritz, S, Messmer, BJ, von Bernuth, G. Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 1997; 114: 578–585.CrossRefGoogle ScholarPubMed
18. Rappaport, LA, Wypij, D, Bellinger, DC, et al. . Relation of seizures after cardiac surgery in early infancy to neurodevelopmental outcome. Circulation 1998; 97: 773–779.CrossRefGoogle ScholarPubMed
19. Clancy, RR, McGaum, SA, Wernovsky, G, et al. . Risk of seizures in survivors of newborn heart surgery using deep hypothermic circulatory arrest. Pediatrics 2003; 111: 592–601.CrossRefGoogle ScholarPubMed
20. Arvio, M, Sillanpää, M. Prevalence, aetiology and comorbidity of severe and profound intellectual disability in Finland. J Intellect Disabil Res 2003; 47: 108–112.CrossRefGoogle ScholarPubMed
21. Williams, GD, Ramamoorthy, C. Brain monitoring and protection during pediatric cardiac surgery. Semin Cardiothorac Vasc Anesth 2007; 11: 23–33.CrossRefGoogle ScholarPubMed
22. Popelova, J, Slavik, Z, Skovranek, J. Are cyanosed adults with congenital cardiac malformations depressed? Cardiol Young 2001; 11: 379–384.CrossRefGoogle ScholarPubMed
23. Gupta, S, Giuffre, RM, Crawford, S, Waters, J. Covert fears, anxiety and depression in congenital heart disease. Cardiol Young 1998; 8: 491–499.CrossRefGoogle ScholarPubMed
24. van Rijen, EHM, Utens, EMWJ, Roos-Hesselink, J, et al. . Medical predictors for psychopathology in adults with operated congenital heart disease. Eur Heart J 2004; 25: 1605–1613.CrossRefGoogle ScholarPubMed
25. Ross, EA, Perloff, JK, Danovitch, GM, Child, JS, Canobbio, MM. Renal function and urate metabolism in late survivors with cyanotic congenital heart disease. Circulation 1986; 73: 396–400.CrossRefGoogle ScholarPubMed