Abstract 11931: Outcomes and Costs of Invasive Cardiac Procedures in Interstage Single Ventricle Patients Admitted Through the Emergency Department

IntroductionSingle ventricle congenital heart disease (SV CHD) patients are at risk of morbidity and mortality between the first and second palliative surgeries (interstage). When these patients present acutely they often require invasive intervention. Limited data exist on outcomes of SV CHD patients who require emergent care. This study sought to compare the outcomes and costs of emergent and elective invasive cardiac procedures for interstage patients.MethodsRetrospective review of discharge data from Vizient (formerly University HealthSystem Consortium), a national administrative database. The database was queried for admissions from October 2014 - December 2017 for children 1-6 months old with ICD-9 or ICD-10 codes for SV CHD who underwent invasive cardiac procedures. Demographics, length of stay (LOS), complication rate, in-hospital mortality and direct costs were compared between emergent and elective admissions using t-test or χ, as appropriate. In addition, the three most frequently performed procedures were compared.ResultsOf the 871 admissions identified, 141 (16%) were emergent. Age of emergent admission was younger than elective (Table 1). Emergent admissions including superior cavo-pulmonary anastomosis or cardiac catheterization had longer LOS and higher costs, but admissions with aorto-pulmonary artery shunts had no differences between groups (Table 2).ConclusionsEmergent admissions for interstage SV CHD patients undergoing superior cavo-pulmonary anastomosis or cardiac catheterization are associated with longer LOS and higher direct costs with no differences in complications or mortality. There is no difference for those undergoing aorto-pulmonary artery shunts, likely reflective of the perioperative fragility of these patients regardless of preoperative status. These findings support aggressive interstage monitoring to minimize the need for emergent interventions for this fragile patient population.