title: Transposition of the great arteries--outcomes and time interval of early neonatal repair.
abstract: BACKGROUND
  This study evaluates the relationship of morbidity and resource utilization with the timing of early neonatal repair of transposition of the great arteries and intact ventricular septum (d-TGA/IVS).
  
  
  METHODS
  All patients with d-TGA/IVS who underwent arterial switch in the first 14 days of life, between January 2000 and May 2011, were reviewed. Patients undergoing repair at ≤ 4 days of age were categorized as group I, 5 to 7 days as group II, and 8 to 14 days as group III. Outcomes included mortality, morbidity, and resource utilization.
  
  
  RESULTS
  Hospital survival was 69 (98.6%) of 70. The length of stay (LOS) and total charges were lowest in group I--15.5 days compared to group II--18.0 days and group III--23.5 days (P = .005); group I--US$128,219 compared to group II--US$141,729 and group III--US$217,427 (P = .0006). Using regression analysis to account for potentially confounding effects of multiple variables and treating time as a continuous variable demonstrated that age at surgery was significantly associated with total LOS (P = .029), hospital charges (P = .029) and intensive care unit charges (P = .002). Younger age at repair was not associated with worse outcomes for any measure of morbidity.
  
  
  CONCLUSIONS
  Earlier repair of d-TGA/IVS was associated with decreased resource utilization and no detriment to clinical outcomes. Further analysis based on a larger cohort of patients is needed to verify these results that have important implications for improving the value of care.
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Cain
authors.forename: Yumei
authors.initials: Y
authors.lastname: Cao
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Ghanayem
authors.forename: Pippa M
authors.initials: PM
authors.lastname: Simpson
authors.forename: Katie
authors.initials: K
authors.lastname: Trapp
authors.forename: Michael E
authors.initials: ME
authors.lastname: Mitchell
authors.forename: James S
authors.initials: JS
authors.lastname: Tweddell
authors.forename: Ronald K
authors.initials: RK
authors.lastname: Woods
mesh_terms: D006348:Cardiac Surgical Procedures / Q000191:economics; D017281:Cost of Illness; D005260:Female; D017722:Hospital Charges; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014188:Transposition of Great Vessels / Q000191:economics / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
keywords: congenital heart disease; great vessel anomaly; neonate; outcomes