6 research outputs found
Assessing enrollment of eligible infants in the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) through linkage to the pediatric cardiac critical care consortium (PC4) registry
Background:The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) lacks a rigorous enrollment audit process, unlike other collaborative networks. Most centers require individual families to consent to participate. It is unknown whether there is variation across centers or biases in enrollment.
Methods:We used the Pediatric Cardiac Critical Care Consortium (PC4) registry to assess enrollment rates in NPC-QIC for those centers participating in both registries using indirect identifiers (date of birth, date of admission, gender, and center) to match patient records. All infants born 1/1/2018-12/31/2020 and admitted 30 days of life were eligible. In PC4, all infants with a fundamental diagnosis of hypoplastic left heart or variant or who underwent a surgical or hybrid Norwood or variant were eligible. Standard descriptive statistics were used to describe the cohort and center match rates were plotted on a funnel chart.
Results:Of 898 eligible NPC-QIC patients, 841 were linked to 1,114 eligible PC4 patients (match rate 75.5%) in 32 centers. Match rates were lower in patients of Hispanic/Latino ethnicity (66.1%, p = 0.005), and those with any specified chromosomal abnormality (57.4%, p = 0.002), noncardiac abnormality (67.8%, p = 0.005), or any specified syndrome (66.5%, p = 0.001). Match rates were lower for patients who transferred to another hospital or died prior to discharge. Match rates varied from 0 to 100% across centers.
Conclusions:It is feasible to match patients between the NPC-QIC and PC4 registries. Variation in match rates suggests opportunities for improvement in NPC-QIC patient enrollment
Effect of Cardiopulmonary Bypass on SARSāCoVā2 Vaccination Antibody Levels
Background Adults undergoing heart surgery are particularly vulnerable to respiratory complications, including COVIDā19. Immunization can significantly reduce this risk; however, the effect of cardiopulmonary bypass (CPB) on immunization status is unknown. We sought to evaluate the effect of CPB on COVIDā19 vaccination antibody concentration after cardiac surgery. Methods and Results This prospective observational clinical trial evaluated adult participants undergoing cardiac surgery requiring CPB at a single institution. All participants received a full primary COVIDā19 vaccination series before CPB. SARSāCoVā2 spike proteināspecific antibody concentrations were measured before CPB (preāCPB measurement), 24āhours following CPB (postoperative day 1 measurement), and approximately 1āmonth following their procedure. Relationships between demographic or surgical variables and change in antibody concentration were assessed via linear regression. A total of 77 participants were enrolled in the study and underwent surgery. Among all participants, mean antibody concentration was significantly decreased on postoperative day 1, relative to preāCPB levels (ā2091āAU/mL, P<0.001). Antibody concentration increased between postoperative day 1and 1 month post CPB measurement (2465āAU/mL, P=0.015). Importantly, no significant difference was observed between preāCPB and 1 month post CPB concentrations (P=0.983). Two participants (2.63%) developed symptomatic COVIDā19 pneumonia postoperatively; 1 case of postoperative COVIDā19 pneumonia resulted in mortality (1.3%). Conclusions COVIDā19 vaccine antibody concentrations were significantly reduced in the shortāterm following CPB but returned to preāCPB levels within 1āmonth. One case of postoperative COVID 19 pneumoniaāspecific mortality was observed. These findings suggest the need for heightened precautions in the perioperative period for cardiac surgery patients