Supplementary Online Content

Gupta P, Beam BW, Noel TR, Dvorchik I, Yin H, Simsic JM, Tobias JD. Impact Of Pre-Operative Location On Outcomes In Congenital Heart Surgery: A Multicenter Analysis

e-Table 1. Patient Characteristics for matched study population: Pages2 and 3

e-Table 2. Study Outcomes stratified by RACHS score for matched study patients:

Page 4

e-Table 3.Study Outcomes stratified by hospital volume for matched study patients: Page 5

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e-Table 1. Study Outcomes stratified by RACHS score for matched study patients

Unmatched
CVICU
(N= 3362) / NICU
(N= 2014) / P-value
Age at procedure (days) / 6 (4, 9) / 8 (5, 13) / <.0001
Birth weight (grams) / 3100 (2700, 3465) / 3090 (2685, 3485) / 0.92
Gestational age (weeks) / 38 (37, 39) / 39 (37, 40) / <.0001
Male sex / 1988 (59.1%) / 1199 (59.5%) / 0.76
Any genetic abnormality / 382 (11.4%) / 261 (12.9%) / 0.08
RACHS score / <.0001
1 / 22 (0.6%) / 11 (0.6%)
2 / 233 (6.9%) / 117 (5.9%)
3 / 1616 (48.1%) / 901 (44.8%)
4 / 700 (20.9%) / 555 (27.6%)
5 / 22 (0.6%) / 14 (0.7%)
6 / 673 (20.1%) / 357 (17.7%)
Use of CPB / 3103 (92.3%) / 1776 (88.2%) / <.0001
Pre-operative prostaglandins / 2733 (81.3%) / 1698 (84.3%) / <.0001
Pre-operative inotropes / 2073 (61.6%) / 970 (48.2%) / <.0001
Pre-operative nitric oxide / 144 (4.3%) / 81 (4.1%) / 0.64
Pre-operative antiepileptics / 46 (1.4%) / 38 (1.9%) / 0.14
Pre-operative CPR / 29 (0.9%) / 13 (0.7%) / 0.38
Pre-operative dialysis / 11 (0.3%) / 4 (0.2%) / 0.39
Pre-operative ECMO / 31 (0.9%) / 11 (0.6%) / 0.13
# Annual CPB cases/center / 476 (291, 522) / 260 (206, 384) / <.0001

Continuous variables are summarized by the triplet of quartiles 50th (25th and 75th). Categorical variables are summarized as N (percent).

P-values were obtained using either the Wilcoxon-Mann-Whitney test for continuous variables, and the Pearson chi-square test for categorical variables.

Abbreviations: NICU: Neonatal Intensive Care Unit; CVICU: Cardiovascular Intensive Care Unit; RACHS: Risk adjustment for Congenital Heart Surgery; CPB: Cardiopulmonary bypass; CPR: Cardiopulmonary resuscitation; ECMO: Extracorporeal membrane oxygenation

e-Table 2. Study Outcomes stratified by RACHS score for matched study patients

RACHS 1-3 / RACHS 4-6
CVICU
(N= 694) / NICU
(N= 683) / P-value / CVICU
(N= 509) / NICU
(N= 522) / P-value
Minor Outcomes
Pre-operative ETT / 116 (16.7%) / 151 (22.1%) / 0.01 / 81 (15.9%) / 118 (22.6%) / <0.0001
Pre-operative NIV / 31 (4.5%) / 47 (6.9%) / 0.05 / 28 (5.5%) / 27 (5.1%) / 0.81
Pre-operative arterial line / 91 (13.1%) / 178 (26.1%) / <0.0001 / 67 (13.2%) / 143 (27.4%) / <0.0001
Pre-operative central line / 279 (40.2%) / 339 (49.6%) / <0.0001 / 182 (35.7%) / 233 (44.6%) / <0.0001
Pre-operative chest tube / 8 (1.2%) / 6 (0.9%) / 0.61 / 1 (0.2%) / 3 (0.6%) / 0.32
*Sepsis / 123 (17.7%) / 137 (20.1%) / 0.26 / 94 (18.5%) / 133 (25.5%) / <0.0001
*Renal failure / 92 (13.3%) / 105 (15.3%) / 0.26 / 93 (18.3%) / 143 (27.4%) / <0.0001
*Seizures / 8 (1.2%) / 2 (0.3%) / 0.06 / 7 (1.4%) / 6 (1.2%) / 0.74
*Necrotizing Enterocolitis / 16 (2.3%) / 15 (2.2%) / 0.89 / 6 (1.2%) / 10 (1.9%) / 0.33
Major Outcomes
Mortality / 46 (6.7%) / 57 (8.4%) / 0.22 / 51 (10.1%) / 81 (15.6%) / 0.008
Pre-operative length of ventilation / 1 (0, 3) / 2 (0, 3) / 0.63 / 1 (0, 3) / 1 (0, 3) / 0.66
Pre-operative hospital LOS / 5 (4, 8) / 6 (4, 9) / <0.0001 / 5 (3, 7) / 6 (4, 8) / <0.0001
Total days of ventilation / 6 (3, 10) / 6 (4, 10) / 0.13 / 7 (4, 12) / 8 (5, 14) / 0.001
Total hospital LOS / 18 (13, 27) / 21 (15, 30) / <0.0001 / 22 (15, 37) / 25 (17, 37) / 0.003
Adjusted billing charges / 289,844
(210,947; 449,224) / 264,069
(178,426; 433,404) / 0.002 / 365,882
(259,885; 588,208) / 311,158
(209,884; 616,117) / 0.003

Continuous variables are summarized by the triplet of quartiles 50th (25th and 75th). Categorical variables are summarized as N (percent). *Outcomes at any point during hospital stay. P-values were obtained using either the Wilcoxon-Mann-Whitney test for continuous variables, and the Pearson chi-square test for categorical variables.

Abbreviations: NICU: Neonatal Intensive Care Unit; CVICU: Cardiovascular Intensive Care Unit; RACHS: Risk adjustment for Congenital Heart Surgery; LOS: Length of stay

e-Table 3. Study Outcomes stratified by hospital volume for matched study patients

Low volume hospitals / High volume hospitals
CVICU
(N= 882) / NICU
(N= 763) / P-value / CVICU
(N=346) / NICU
(N= 465) / P-value
Minor Outcomes
Pre-operative ETT / 136 (15.4%) / 184 (24.1%) / <0.0001 / 69 (19.9%) / 92 (19.7%) / 0.95
Pre-operative NIV / 44 (5.1%) / 30 (3.9%) / 0.30 / 19 (5.5%) / 46 (9.9%) / 0.02
Pre-operative arterial line / 96 (10.9%) / 240 (31.5%) / <0.0001 / 65 (18.8%) / 89 (19.1%) / 0.89
Pre-operative central line / 321 (36.4%) / 410 (53.7%) / <0.0001 / 150 (43.3%) / 174 (37.4%) / 0.08
Pre-operative chest tube / 8 (0.9%) / 7 (0.9%) / 0.98 / 1 (0.3%) / 2 (0.4%) / 0.74
*Sepsis / 147 (16.7%) / 200 (26.2%) / <0.0001 / 76 (21.9%) / 78 (16.8%) / 0.06
*Renal failure / 132 (14.9%) / 137 (17.9%) / 0.10 / 60 (17.4%) / 116 (24.9%) / 0.009
*Seizures / 10 (1.1%) / 4 (0.5%) / 0.18 / 6 (1.8%) / 4 (0.8%) / 0.26
*Necrotizing Enterocolitis / 8 (0.9%) / 16 (2.1%) / 0.04 / 14 (4.1%) / 9 (1.9%) / 0.07
Major Outcomes
Mortality / 75 (8.5%) / 101 (13.2%) / <0.0001 / 33 (9.5%) / 45 (9.6%) / 0.95
Pre-operative length of ventilation / 2 (0, 3) / 2 (0, 4) / 0.38 / 1 (0, 3) / 1 (0, 3) / 0.51
Pre-operative hospital LOS / 5 (3, 7) / 6 (4, 8) / <0.0001 / 6 (4, 8) / 6 (4, 9) / 0.03
Total days of ventilation / 7 (4, 11) / 8 (4, 13) / <0.0001 / 5 (2, 11) / 6 (4, 10) / <0.0001
Total hospital LOS / 18 (13, 28) / 21 (15, 32) / <0.0001 / 24 (15, 41) / 23 (17, 35) / 0.95
Adjusted billing charges / 306,244
(218,066; 466,112) / 343,449
(206,935; 630,578) / <0.0001 / 365,537
(248,471; 658,661) / 243,133
(178,426; 352,564) / <0.0001

Continuous variables are summarized by the triplet of quartiles 50th (25th and 75th). Categorical variables are summarized as N (percent).

P-values were obtained using either the Wilcoxon-Mann-Whitney test for continuous variables, and the Pearson chi-square test for categorical variables. *Outcomes at any point during hospital stay

Abbreviations: NICU: Neonatal Intensive Care Unit; CVICU: Cardiovascular Intensive Care Unit; RACHS: Risk adjustment for Congenital Heart Surgery; LOS: Length of stay

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