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Patients with Single-Ventricle Physiology over the Age of 40 Years

Background: Single-ventricle physiology (SVP) is associated with significant morbidity and mortality at a young age. However, survival prospects have improved and risk factors for a negative outcome are well described in younger cohorts. Data regarding older adults is scarce. Methods: In this study,...

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Autores principales: Pujol, Claudia, Schiele, Sandra, Maurer, Susanne J., Hock, Julia, Fritz, Celina, Hager, Alfred, Ewert, Peter, Tutarel, Oktay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765901/
https://www.ncbi.nlm.nih.gov/pubmed/33352831
http://dx.doi.org/10.3390/jcm9124085
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author Pujol, Claudia
Schiele, Sandra
Maurer, Susanne J.
Hock, Julia
Fritz, Celina
Hager, Alfred
Ewert, Peter
Tutarel, Oktay
author_facet Pujol, Claudia
Schiele, Sandra
Maurer, Susanne J.
Hock, Julia
Fritz, Celina
Hager, Alfred
Ewert, Peter
Tutarel, Oktay
author_sort Pujol, Claudia
collection PubMed
description Background: Single-ventricle physiology (SVP) is associated with significant morbidity and mortality at a young age. However, survival prospects have improved and risk factors for a negative outcome are well described in younger cohorts. Data regarding older adults is scarce. Methods: In this study, SVP patients under active follow-up at our center who were ≥40 years of age at any point between January 2005 and December 2018 were included. Demographic data, as well as medical/surgical history were retrieved from hospital records. The primary end-point was all-cause mortality. Results: Altogether, 49 patients (19 female (38.8%), mean age 49.2 ± 6.4 years) were included. Median follow-up time was 4.9 years (interquartile range (IQR): 1.8–8.5). Of these patients, 40 (81.6%) had undergone at least one cardiac surgery. The most common extracardiac comorbidities were thyroid dysfunction (n = 27, 55.1%) and renal disease (n = 15, 30.6%). During follow-up, 10 patients (20.4%) died. On univariate analysis, renal disease and liver cirrhosis were predictors of all-cause mortality. On multivariate analysis, only renal disease (hazard ratio (HR): 12.5, 95% confidence interval (CI): 1.5–106.3, p = 0.021) remained as an independent predictor. Conclusions: SVP patients ≥40 years of age are burdened with significant morbidity and mortality. Renal disease is an independent predictor of all-cause mortality.
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spelling pubmed-77659012020-12-28 Patients with Single-Ventricle Physiology over the Age of 40 Years Pujol, Claudia Schiele, Sandra Maurer, Susanne J. Hock, Julia Fritz, Celina Hager, Alfred Ewert, Peter Tutarel, Oktay J Clin Med Article Background: Single-ventricle physiology (SVP) is associated with significant morbidity and mortality at a young age. However, survival prospects have improved and risk factors for a negative outcome are well described in younger cohorts. Data regarding older adults is scarce. Methods: In this study, SVP patients under active follow-up at our center who were ≥40 years of age at any point between January 2005 and December 2018 were included. Demographic data, as well as medical/surgical history were retrieved from hospital records. The primary end-point was all-cause mortality. Results: Altogether, 49 patients (19 female (38.8%), mean age 49.2 ± 6.4 years) were included. Median follow-up time was 4.9 years (interquartile range (IQR): 1.8–8.5). Of these patients, 40 (81.6%) had undergone at least one cardiac surgery. The most common extracardiac comorbidities were thyroid dysfunction (n = 27, 55.1%) and renal disease (n = 15, 30.6%). During follow-up, 10 patients (20.4%) died. On univariate analysis, renal disease and liver cirrhosis were predictors of all-cause mortality. On multivariate analysis, only renal disease (hazard ratio (HR): 12.5, 95% confidence interval (CI): 1.5–106.3, p = 0.021) remained as an independent predictor. Conclusions: SVP patients ≥40 years of age are burdened with significant morbidity and mortality. Renal disease is an independent predictor of all-cause mortality. MDPI 2020-12-18 /pmc/articles/PMC7765901/ /pubmed/33352831 http://dx.doi.org/10.3390/jcm9124085 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pujol, Claudia
Schiele, Sandra
Maurer, Susanne J.
Hock, Julia
Fritz, Celina
Hager, Alfred
Ewert, Peter
Tutarel, Oktay
Patients with Single-Ventricle Physiology over the Age of 40 Years
title Patients with Single-Ventricle Physiology over the Age of 40 Years
title_full Patients with Single-Ventricle Physiology over the Age of 40 Years
title_fullStr Patients with Single-Ventricle Physiology over the Age of 40 Years
title_full_unstemmed Patients with Single-Ventricle Physiology over the Age of 40 Years
title_short Patients with Single-Ventricle Physiology over the Age of 40 Years
title_sort patients with single-ventricle physiology over the age of 40 years
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765901/
https://www.ncbi.nlm.nih.gov/pubmed/33352831
http://dx.doi.org/10.3390/jcm9124085
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