SCCM Resource Library-Predictors of Treatment Success Among Patients with Atrial Septal Defect and Pulmonary Hypertension who Underwent Device or Surgical Closure

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The document discusses a study conducted by Dr. Rona Barbie O. Mendoza and Dr. Jhoanna G. Marcelo from the Philippine Heart Center. The study aims to identify predictors of treatment success for adult patients with atrial septal defect (ASD) and pulmonary hypertension (PH) who underwent either device or surgical closure procedures. The Society of Critical Care Medicine does not endorse the resource.<br /><br /><strong>Summary of Study:</strong><br /><br /><strong>Purpose:</strong> <br />The study seeks to determine predictors of successful treatment outcomes in adult ASD patients with PH and to develop a scoring system based on these predictors.<br /><br /><strong>Methods:</strong><br />- The study involved adult patients with ASD and PH who had undergone hemodynamic studies before their closure procedures.<br />- Data on treatment outcomes collected during hospital stays were analyzed.<br />- Multiple logistic regression analyses were performed to identify significant factors influencing treatment success.<br /><br /><strong>Results:</strong><br />- Total of 297 patients were included, with 269 patients (90.57%) experiencing successful ASD closure.<br />- Significant factors associated with successful closure:<br />   - Left atrial (LA) size <37mm [Odds Ratio (OR) 12.31; P-value < 0.001; Beta coefficient 2.51]<br />   - Pulmonary Hypertension severity < 70 mmHg (OR 10.85; P < 0.0002; Beta coefficient 2.75)<br />   - Systemic Vascular Resistance (SVR) < 942 dynes/seconds/cm-5 (OR 6.08; P = 0.002; Beta coefficient 1.81)<br /><br /><strong>Scoring System:</strong><br />- A scoring system was created ranging from 0 to 6 based on log-odds ratios (beta coefficients).<br />- A score of 3 or higher indicates an increased likelihood of successful closure.<br />- The system showed good discriminative ability with 75.09% accuracy, 73.88% sensitivity, and 88% specificity.<br /><br /><strong>Conclusion:</strong><br />- The scoring system, including LA size, PH severity, and SVR, can help identify ASD patients with PH who are more likely to achieve successful closure through procedural interventions.<br /><br />This research offers a practical tool for clinicians to forecast treatment outcomes in ASD patients with PH, potentially improving decision-making and patient management.

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Cardiovascular, Procedures, 2024, 0:15:00

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Content Type Article

Knowledge Area Cardiovascular

Knowledge Area Procedures

Membership Level Nonmember

Membership Level Associate

Membership Level Professional

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Tag Surgery

Year 2024

Keywords

atrial septal defect

pulmonary hypertension

treatment success predictors

device closure

surgical closure

scoring system

logistic regression

Philippine Heart Center

hemodynamic studies

clinical outcomes

Article

Cardiovascular

Procedures

Surgery

2024

Nonmember

Associate

Professional

Select

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