影響兒童先天性心臟病死亡率之分析—以大動脈轉位類型為例

林啟文

doi:10.6822/CTUST.2012.00035

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影響兒童先天性心臟病死亡率之分析—以大動脈轉位類型為例

Factors Influencing Mortality of Children with Congenital Heart Disease --- A Population-Based Study of Transposition of the Great Arteries

林啟文 , Masters　　Advisor：洪錦墩　　

繁體中文 DOI： 10.6822/CTUST.2012.00035

先天性心臟病；死亡率；健康保險； Health Insurance ； Congenital Heart Disease ； Mortality

Abstract │ Reference (67) │ Altmetrics

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OBJECTIVE: The transposition of greater arteries (TGA) was the severe cyanotic congenital heart disease. The children with TGA survived after receiving Arterial Switch Operation (ASO) early. There were complexity and high risk of mortality within ASO procedure and the mortality rate of ASO could be the care quality of pediatric cardiology. To understand the mortality and influencing factors of the children with TGA could establish the care quality level of pediatric cardiology, decrease the uncertain sense of family and formulate the care policy in Taiwan.
METHOD: This was a population-based study using administrative data from the secondary database of the Bureau of National Health Insurance. A retrospective cohort design was employed to identify the TGA infants hospitalized during the period of 1997-2009. The cases enrolled into this study were compatible with a diagnosis of TGA according to the ICD-9 classification. The TGA patients associated with ASD and/or PDA are defined as ‘simple TGA’, while those associated with other complex CHDs are defined as ‘complex TGA’. The gender, age and institutional experience were classified as variables. We analyzed the mortality and the influencing factors by the discharge situation of the hospital and the insurance termination date of children.
RESULTS: The TGA is the second most common cyanotic congenital heart disease in children. The most optimal timing for ASO is within one month of life. The mortality of TGA was significantly related to age, complexity of disease. The operative mortality of ASO procedure was significantly related to institutional experience.
CONCLUSION: The survival of children with TGA was influenced by younger age, simple disease, and the survival of children receiving ASO was influenced by the institution experience.

Reference ( 67 ) 〈TOP〉

李淑莉、陳月枝(2001)。兒童經歷開心手術治療過程母親的壓力源及因應行為。護理研究，9(2)，172-181。
連結：
許國正(2005)。先天性心臟病患童父母於開心手術前後需求之探討。慈濟護理雜誌，4(4)，40-48。
連結：
Archer, J. M., Yeager, S. B., Kenny, M. J., Soll, R. F., & Horbar, J. D. (2011). Distribution of and Mortality From Serious Congenital Heart Disease in Very Low Birth Weight Infants. Pediatrics,127,1-7
連結：
Aronson, P. L., & Chen, J. (2011). The Neonate After Cardiac Surgery : What do You Need to Worry About in the Emergency Department ? Neonate After Cardiac Surgery,12(4),313-322
連結：
Bellinger, D. C., Wypij, D., Rivkin, M. J., DeMaso, D. R., Robertson, R. L., Dunbar-Masterson, C., Rappaport, L., Werbnovsky, G., Jonas, R. A., & Newburger, J. W. (2011). Adolescents with d-Transposition of the Great Arteries Corrected with the Arterial Switch Procedure Neuropsychological Assessment and Structural Brain Imaging. Circulation,124,1-9
連結：

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