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PEDIATRICS Vol. 113 No. 2 February 2004, pp. 431-432

Management of Hypoplastic Left Heart Syndrome

John M. Tilford, PhD
Mario A. Cleves, PhD
Sadia Ghaffar, MD, MPH
Center for Birth Defects Research and Prevention; University of Arkansas for Medical Sciences and; Arkansas Children’s Hospital; Little Rock, AR 72202-3591, USA

The first 20% of the full text of this article appears below.

To the Editor.—

We read with interest the paper by Chang et al1 on the management of hypoplastic left heart syndrome (HLHS) in newborn infants. They used data from the Nationwide Inpatient Sample (NIS) covering the years 1988–1997 to examine trends in the use of the Norwood procedure, heart transplantation, and mortality over time. They also examined patient and hospital characteristics to assess whether they had any influence on management decisions. Chang et al claimed the in-hospital mortality rate fell from 54.4% in 1988 to 38.1% in 1997 and use of the Norwood procedure increased from 8% to 34% over the same time period. They also found that hospitals in the South were more likely to use the Norwood procedure relative to other regions of the country—a finding that "cannot be easily explained." In this letter, we address these findings.

Central to the Chang et al analysis is the development of the sample from the NIS. They claim to have identified patients in the NIS with multiple hospitalizations. This . . . [Full Text of this Article]




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