Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery

© 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Assessing the neurodevelopmental status of infants with congenital heart disease before surgery provides a means of identifying those at heightened risk of developmental delay. This study aimed to inves...

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Main Authors: Campbell, M., Rabbidge, B., Ziviani, J., Sakzewski, Leanne
Format: Journal Article
Published: Wiley-Blackwell Publishing Ltd. 2017
Online Access:http://hdl.handle.net/20.500.11937/71852
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author Campbell, M.
Rabbidge, B.
Ziviani, J.
Sakzewski, Leanne
author_facet Campbell, M.
Rabbidge, B.
Ziviani, J.
Sakzewski, Leanne
author_sort Campbell, M.
building Curtin Institutional Repository
collection Online Access
description © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Assessing the neurodevelopmental status of infants with congenital heart disease before surgery provides a means of identifying those at heightened risk of developmental delay. This study aimed to investigate factors impacting clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing early open heart surgery. Methods: Infants who underwent open heart surgery prior to 4 months of age participated in this cross-sectional study. The Test of Infant Motor Performance and Prechtl's Assessment of General Movements were undertaken on infants pre-operatively. When assessments could not be undertaken, reasons were ascribed to either infant or environmental circumstances. Demographic data and Aristotle scores were compared between groups of infants who did or did not undergo assessment. Binary logistic regression was used to explore associations. Results: A total of 60 infants participated in the study. Median gestational age was 38.78 weeks (interquartile range: 36.93–39.72). Of these infants, 37 (62%) were unable to undergo pre-operative assessment. Twenty-four (40%) could not complete assessment due to infant-related factors and 13 (22%) due to environmental-related factors. For every point increase in the Aristotle Patient-Adjusted Complexity score, the infants likelihood of being unable to undergo assessment increased by 35% (odds ratio: 0.35; 95% confidence interval: 1.03–1.77, P = 0.03). Conclusion: Over half of the infants undergoing open heart surgery were unable to complete pre-operative neurodevelopmental assessment. The primary reason for this was infant-related medical instability. Findings suggest further research is warranted to investigate whether the Aristotle Patient-Adjusted Complexity score might serve as an indicator to inform developmental surveillance with this medically fragile cohort.
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spelling curtin-20.500.11937-718522018-12-13T09:33:19Z Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery Campbell, M. Rabbidge, B. Ziviani, J. Sakzewski, Leanne © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Assessing the neurodevelopmental status of infants with congenital heart disease before surgery provides a means of identifying those at heightened risk of developmental delay. This study aimed to investigate factors impacting clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing early open heart surgery. Methods: Infants who underwent open heart surgery prior to 4 months of age participated in this cross-sectional study. The Test of Infant Motor Performance and Prechtl's Assessment of General Movements were undertaken on infants pre-operatively. When assessments could not be undertaken, reasons were ascribed to either infant or environmental circumstances. Demographic data and Aristotle scores were compared between groups of infants who did or did not undergo assessment. Binary logistic regression was used to explore associations. Results: A total of 60 infants participated in the study. Median gestational age was 38.78 weeks (interquartile range: 36.93–39.72). Of these infants, 37 (62%) were unable to undergo pre-operative assessment. Twenty-four (40%) could not complete assessment due to infant-related factors and 13 (22%) due to environmental-related factors. For every point increase in the Aristotle Patient-Adjusted Complexity score, the infants likelihood of being unable to undergo assessment increased by 35% (odds ratio: 0.35; 95% confidence interval: 1.03–1.77, P = 0.03). Conclusion: Over half of the infants undergoing open heart surgery were unable to complete pre-operative neurodevelopmental assessment. The primary reason for this was infant-related medical instability. Findings suggest further research is warranted to investigate whether the Aristotle Patient-Adjusted Complexity score might serve as an indicator to inform developmental surveillance with this medically fragile cohort. 2017 Journal Article http://hdl.handle.net/20.500.11937/71852 10.1111/jpc.13565 Wiley-Blackwell Publishing Ltd. restricted
spellingShingle Campbell, M.
Rabbidge, B.
Ziviani, J.
Sakzewski, Leanne
Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery
title Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery
title_full Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery
title_fullStr Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery
title_full_unstemmed Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery
title_short Clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery
title_sort clinical feasibility of pre-operative neurodevelopmental assessment of infants undergoing open heart surgery
url http://hdl.handle.net/20.500.11937/71852