Prevalence and Risk Factors for Tube-Feeding at Discharge in Infants following Early Congenital Heart Disease Surgery: A Single-Center Cohort Study

Sreekanth Viswanathan; Kaitlyn Jade F. Ong; Bahram Kakavand

doi:10.1055/s-0043-1775976

American Journal of Perinatology, Table of Contents

Am J Perinatol 2024; 41(S 01): e2832-e2841
DOI: 10.1055/s-0043-1775976

Original Article

Prevalence and Risk Factors for Tube-Feeding at Discharge in Infants following Early Congenital Heart Disease Surgery: A Single-Center Cohort Study

Sreekanth Viswanathan

¹Division of Neonatology, Department of Pediatrics, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, Florida

,

Kaitlyn Jade F. Ong

¹Division of Neonatology, Department of Pediatrics, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, Florida

,

Bahram Kakavand

²Department of Pediatrics, Division of Pediatric Cardiology, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, Florida

› Author Affiliations

Abstract

Objective Oral feeding difficulty is common in infants after congenital heart disease (CHD) surgical repair and is associated with prolonged hospital stay and increased risk for tube-feeding at discharge (TF). The current understanding of the enteropathogenesis of oral feeding difficulty in infants requiring CHD surgery is limited. To determine the prevalence and risk factors for TF following CHD surgery in early infancy.

Study Design This was a 6-year single-center retrospective cohort study (2016–2021) of infants under 6 months who had CHD surgery. Infants required TF were compared with infants who reached independent oral feeding (IOF).

Results Of the final sample of 128 infants, 24 (18.8%) infants required TF at discharge. The risk factors for TF in univariate analysis include low birth weight, low 5-minute Apgar score, admitted at birth, risk adjustment in congenital heart surgery categories IV to VI, presence of genetic diagnosis, use of Prostin, higher pre- and postsurgery respiratory support, lower weight at surgery, lower presurgery oral feeding, higher presurgery milk calory, delayed postsurgery enteral and oral feeding, higher pre- and postsurgery gastroesophageal reflux disease (GERD), need for swallow study, abnormal brain magnetic resonance imaging (p < 0.05). In the multivariate analysis, only admitted at birth, higher presurgery milk calories, and GERD were significant risk factors for TF. TF had significantly longer hospital stay (72 vs. 17 days) and lower weight gain at discharge (z-score: −3.59 vs. −1.94) compared with IOF (p < 0.05).

Conclusion The prevalence of TF at discharge in our study is comparable to previous studies. Infants with CHD admitted at birth, received higher presurgery milk calories, and clinical GERD are significant risk factors for TF. Mitigating the effects of identified risk factors for TF will have significant impact on the quality of life for these infants and their families and may reduce health care cost.

Key Points

Oral feeding difficulty in infants after congenital heart disease surgical repair is common.
Such infants require prolonged hospital stay and higher risk for tube-feeding at discharge.
Identifying modifiable risk factors associated with tube-feeding can enhance clinical outcomes.

Keywords

oral feeding difficulty - congenital heart surgery - infants - dysphagia

Full Text

References

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