What question did this study set out to answer?

The aim is to evaluate how surgical timing affects morbidity and hospital costs in neonates with d-TGA.

July 3, 2026Journal of the American College of Cardiology

Earlier Arterial Switch Operation Improves Outcomes and Reduces Costs for Neonates With Transposition of the Great Arteries

Q: What are the key findings of this study?

Delaying neonatal arterial switch operation beyond 3 days of life increased the odds of major morbidity by 47% per day (OR 1.47; 95% CI 1.23-1.66; p<0.001) and increased costs by 8% per day.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: dextrotransposition of the great arteries (d-TGA) (n=140). Intervention: Delay of neonatal arterial switch operation beyond day of life 3 vs. Earlier operation. Primary outcome: Major morbidity (OR 1.47, 95% CI 1.23-1.66, p=<0.001).

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Key result

Delaying neonatal arterial switch beyond 3 days is linked to ~47% higher morbidity per day.

OR 1.47
95% CI 1.23-1.66
P<0.001
n=140

Why the study?

Does delaying arterial switch operation beyond 3 days of life increase major morbidity and costs in neonates with d-TGA?

Population

140 late preterm and term infants with dextrotransposition of the great arteries, with or without…

Comparison

Delay of neonatal arterial switch operation… vs Neonatal arterial switch operation performed at…

Design

Cohort

Authors

BABrett R. AndersonPediatric Cardiology ACAdam CiarleglioGeorge Washington University DHDenise A. HayesNorthwell Health

Discussion

Member takes

Implication

Delaying the neonatal arterial switch operation beyond 3 days of life in infants with d-TGA is associated with significantly increased major morbidity and healthcare costs.

Key Points

The aim is to evaluate how surgical timing affects morbidity and hospital costs in neonates with d-TGA.
Conducted a retrospective cohort study of infants ≥36 weeks' gestation with d-TGA admitted at 5 days of age or younger
Performed univariable and multivariable analyses to assess impact of age at operation on morbidity and reimbursement
Included 140 included infants, with reimbursement data for 128 through January 1, 2012.
Mortality rate was 1.4% (n=2) among the cohort
20% (n=28) of infants experienced major morbidity
Delayed surgery past 3 days increased morbidity by 47% (p<0.001) and costs by 8% (p<0.001).

Study Design

Type

Cohort (n=140)

Multicenter

Structured PICO

Does delaying arterial switch operation beyond 3 days of life increase major morbidity and costs in neonates with d-TGA?

Population

140 late preterm and term infants with dextrotransposition of the great arteries admitted at ≤5 days of age, evaluated for the impact of surgical timing on morbidity and costs.

Exposure

Delay of neonatal arterial switch operation beyond 3 days of life

Comparator

Neonatal arterial switch operation performed at 3 days of life or earlier

Outcome

Major morbidity and hospital reimbursement (costs)composite

Main Result

Odds Ratio: 1.47 (95% CI 1.23–1.66)

p-value: p=<0.001

Delaying the neonatal arterial switch operation beyond 3 days of life in infants with d-TGA is associated with significantly increased major morbidity and healthcare costs.

Cite This Study

Anderson et al. (2013) conducted a cohort in dextrotransposition of the great arteries (d-TGA) (n=140). Delay of neonatal arterial switch operation beyond day of life 3 vs. Earlier operation was evaluated on Major morbidity (OR 1.47, 95% CI 1.23-1.66, p=<0.001). Delaying neonatal arterial switch operation beyond 3 days of life increased the odds of major morbidity by 47% per day (OR 1.47; 95% CI 1.23-1.66; p<0.001) and increased costs by 8% per day.

synapsesocial.com/papers/6a47d2ecad3d0ceaee1001a7 https://doi.org/10.1016/j.jacc.2013.08.1645

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Implication

Delaying the neonatal arterial switch operation beyond 3 days of life in infants with d-TGA is associated with significantly increased major morbidity and healthcare costs.

Earlier Arterial Switch Operation Improves Outcomes and Reduces Costs for Neonates With Transposition of the Great Arteries

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Earlier Arterial Switch Operation Improves Outcomes and Reduces Costs for Neonates With Transposition of the Great Arteries

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider