TY - JOUR
T1 - Hypoalbuminemia and poor growth predict worse outcomes in pediatric heart transplant recipients
AU - Castleberry, Chesney
AU - White-Williams, Connie
AU - Naftel, David
AU - Tresler, Margaret A.
AU - Pruitt, Elizabeth
AU - Miyamoto, Shelley D.
AU - Murphy, Debbie
AU - Spicer, Robert
AU - Bannister, Louise
AU - Schowengerdt, Kenneth
AU - Gilmore, Lisa
AU - Kaufman, Beth
AU - Zangwill, Steven
PY - 2014
Y1 - 2014
N2 - Children with end-stage cardiac failure are at risk of HA and PG. The effects of these factors on post-transplant outcome are not well defined. Using the PHTS database, albumin and growth data from pediatric heart transplant patients from 12/1999 to 12/2009 were analyzed for effect on mortality. Covariables were examined to determine whether HA and PG were risk factors for mortality at listing and transplant. HA patients had higher waitlist mortality (15.81% vs. 10.59%, p = 0.015) with an OR of 1.59 (95% CI 1.09-2.30). Survival was worse for patients with HA at listing and transplant (p ≤ 0.01 and p = 0.026). Infants and patients with congenital heart disease did worse if they were HA at time of transplant (p = 0.020 and p = 0.028). Growth was poor while waiting with PG as risk factor for mortality in multivariate analysis (p = 0.008). HA and PG are risk factors for mortality. Survival was worse in infants and patients with congenital heart disease. PG was a risk factor for mortality in multivariate analysis. These results suggest that an opportunity may exist to improve outcomes for these patients by employing strategies to mitigate these risk factors.
AB - Children with end-stage cardiac failure are at risk of HA and PG. The effects of these factors on post-transplant outcome are not well defined. Using the PHTS database, albumin and growth data from pediatric heart transplant patients from 12/1999 to 12/2009 were analyzed for effect on mortality. Covariables were examined to determine whether HA and PG were risk factors for mortality at listing and transplant. HA patients had higher waitlist mortality (15.81% vs. 10.59%, p = 0.015) with an OR of 1.59 (95% CI 1.09-2.30). Survival was worse for patients with HA at listing and transplant (p ≤ 0.01 and p = 0.026). Infants and patients with congenital heart disease did worse if they were HA at time of transplant (p = 0.020 and p = 0.028). Growth was poor while waiting with PG as risk factor for mortality in multivariate analysis (p = 0.008). HA and PG are risk factors for mortality. Survival was worse in infants and patients with congenital heart disease. PG was a risk factor for mortality in multivariate analysis. These results suggest that an opportunity may exist to improve outcomes for these patients by employing strategies to mitigate these risk factors.
KW - heart transplant
KW - hypoalbuminemia
KW - nutrition
KW - outcomes
KW - pediatric
KW - weight
UR - http://www.scopus.com/inward/record.url?scp=84898458584&partnerID=8YFLogxK
U2 - 10.1111/petr.12239
DO - 10.1111/petr.12239
M3 - Article
C2 - 24646199
AN - SCOPUS:84898458584
SN - 1397-3142
VL - 18
SP - 280
EP - 287
JO - Pediatric transplantation
JF - Pediatric transplantation
IS - 3
ER -