Key result
In patients with single-ventricle physiology over 40 years of age, renal disease was a strong independent predictor of all-cause mortality (HR 12.5).
Why the study?
Risk factors for negative outcomes in single-ventricle physiology are well described in younger cohorts, but data regarding older adults are scarce.
What are the predictors of all-cause mortality in patients with single-ventricle physiology over the age of 40 years?
Cohort (n=49)
No
What are the predictors of all-cause mortality in patients with single-ventricle physiology over the age of 40 years?
In older adults (≥40 years) with single-ventricle physiology, renal disease is a strong independent predictor of all-cause mortality.
Answers are grounded in this paper and cite their sources.
Renal disease may identify higher-risk SVP adults ≥40 years; leaves open whether targeted interventions improve survival in this population.
Background: Single-ventricle physiology (SVP) is associated with significant morbidity and mortality at a young age. However, survival prospects have improved and risk factors for a negative outcome are well described in younger cohorts. Data regarding older adults is scarce. Methods: In this study, SVP patients under active follow-up at our center who were ≥40 years of age at any point between January 2005 and December 2018 were included. Demographic data, as well as medical/surgical history were retrieved from hospital records. The primary end-point was all-cause mortality. Results: Altogether, 49 patients (19 female (38.8%), mean age 49.2 ± 6.4 years) were included. Median follow-up time was 4.9 years (interquartile range (IQR): 1.8–8.5). Of these patients, 40 (81.6%) had undergone at least one cardiac surgery. The most common extracardiac comorbidities were thyroid dysfunction (n = 27, 55.1%) and renal disease (n = 15, 30.6%). During follow-up, 10 patients (20.4%) died. On univariate analysis, renal disease and liver cirrhosis were predictors of all-cause mortality. On multivariate analysis, only renal disease (hazard ratio (HR): 12.5, 95% confidence interval (CI): 1.5–106.3, p = 0.021) remained as an independent predictor. Conclusions: SVP patients ≥40 years of age are burdened with significant morbidity and mortality. Renal disease is an independent predictor of all-cause mortality.
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Pujol et al. (2020) conducted a cohort in Single-ventricle physiology (n=49). Renal disease vs. Absence of renal disease was evaluated on All-cause mortality (HR 12.5, 95% CI 1.5-106.3, p=0.021). In patients with single-ventricle physiology over 40 years of age, renal disease was a strong independent predictor of all-cause mortality (HR 12.5).
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