Frequencies, timings, weights, in-hospital and interstage outcomes for staged treatment of HLHS
| Frequency (%) | Median age (IQR) | Median length of stay (IQR) | Median weight (kg) (IQR) | In-hospital mortality (%) (95% CI) | Interstage mortality (%) (95% CI) | |
| Early era | ||||||
| Traditional pathway | 296 (30.3) | |||||
| Prepathway | 14 (4.7) | 2 (2–4) days | 7 (2–17) days | 3.1 (2.0–3.5) | 35.7 (12.8 to 64.9) | |
| Stage 1 | 290 (98.0) | 4 (3–7) days | 16 (10–26) days | 3.1 (2.7–3.4) | 30.0 (24.8 to 35.9)* | 13.6 (9.3 to 18.8) |
| Stage 2 | 169 (57.1) | 5.7 (4.7–7.7) months† | 8 (6–14) days | 6.4 (5.6–7.0) | 1.8 (0.4 to 5.1) | 6.8 (3.6 to 11.4) |
| Stage 3 | 141 (47.6) | 52.0 (41.4–64.2) months | 14 (9–22) days | 15.5 (14.0–16.8) | 2.1 (0.4 to 6.1) | |
| Heart transplant | 9 (3.0) | 38.6 (18.8–79.8) months | 20 (17–26) days | 15.5 (10.0–16.8) | 0.0 (0.0 to 33.6) | |
| Recent era | ||||||
| Traditional pathway | 618 (63.3) | |||||
| Prepathway | 79 (12.8) | 3 (1–7) days | 9 (2–21) days | 3.0 (2.6–3.4) | 34.2 (23.9 to 45.7) | |
| Stage 1 | 584 (94.5) | 4 (3–6) days | 20 (11–33) days | 3.1 (2.8–3.5) | 19.0 (15.9 to 22.4)* | 11.3 (8.6 to 14.4) |
| Stage 2 | 394 (63.8) | 5.1 (4.0–6.3) months† | 8 (6–16) days | 6.1 (5.3–6.9) | 4.1 (2.3 to 6.5) | 7.8 (5.0 to 11.2) |
| Stage 3 | 182 (29.4) | 48.5 (39.5–55.6) months | 16 (11–23) days | 15.2 (13.7–16.7) | 0.5 (0.0 to 3.0) | |
| Heart transplant | 8 (1.3) | 35.4 (3.4–61.0) months | 55 (32–71) days | 13.5 (5.1–15.6) | 12.5 (0.3 to 52.7) | |
| Hybrid pathway | 62 (6.4) | |||||
| Prepathway | 1 (1.6) | 0 (0–0) days | 6 (6–6) days | 3.7 (3.7–3.7) | ‡ | |
| Hybrid | 62 (100.0) | 5 (3–7) days | 18 (7–30) days | 2.7 (2.3–3.2) | 25.8 (15.5 to 38.5) | |
| Stage 1 | 18 (29.0) | 77 (66–99) days | 19 (10–62) days | 3.1 (2.8–4.1) | 11.1 (1.4 to 34.7) | 28.6 (15.9 to 42.6)§ |
| Stage 2 | 13 (21.0) | 7.1 (5.9–8.5) months | 18 (7–37) days | 5.7 (4.7–6.5) | 0.0 (0.0 to 24.7) | |
| Comprehensive stage 2 | 14 (22.6) | 3.9 (3.7–5.2) months | 15 (9–37) days | 4.8 (4.2–5.7) | 14.3 (1.8 to 42.8) | 4.0 (0.0 to 17.0)¶ |
| Stage 3 | 9 (14.5) | 42.1 (33.9–45.5) months | 14 (11–19) days | 13.5 (11.9–15.0) | 0.0 (0.0 to 33.6) | |
| Heart transplant | 1 (1.6) | 3.1 (3.1–3.1) months | 148 (148–148) days | 3.6 (3.6–3.6) | 0.0 (0.0 to 97.5) | |
*The χ2 test showed a significant reduction in hospital mortality for stage 1 surgery (P<0.001) between the early and recent eras.
↵†Competing risks analysis showed there was a significant reduction in age at stage 2 surgery (P<0.001) between the early and recent eras.
‡The inclusion criterion for the hybrid pathway was a patient undergoing a hybrid procedure, so the survival following any prepathway procedures was necessarily 100% for this group of patients.
§This includes all mortality following discharge from the hybrid approach procedure until completion of stage 2.
¶This includes all mortality following discharge from either the traditional stage 2 procedure or the comprehensive stage 2 procedure until the completion of stage 3.
HLHS, hypoplastic left heart syndrome.