| アブストラクト | Pediatric cardiac catheterization requires unconsciousness and immobilization through general anesthesia or sedation. This study aimed to compare the occurrence of severe complications in pediatric diagnostic cardiac catheterization for ventricular septal defect between general anesthesia and sedation performed under similar institutional environments. Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified pediatric patients (aged <2 years) who underwent diagnostic cardiac catheterization for ventricular septal defect between July 2010 and March 2019. The composite outcome was the occurrence of severe complications, including catecholamine use and intensive care unit admission, within seven days after catheterization. Overlap weighting based on propensity scores was used to adjust for patient- and hospital-level confounding factors. We identified 3159 patients from 87 hospitals, including 930 under general anesthesia and 2229 under sedation. The patient- and hospital-level baseline characteristics differed between the groups. After adjustment, the proportion of patients with severe complications was significantly higher in the general anesthesia group than in the sedation group (2.4% vs. 0.6%; risk difference, 1.8% [95% confidence interval, 0.93-2.6%]). Severe complications occurred more frequently in the general anesthesia group than in the sedation group. Further research on anesthetic methods is necessary to assess the safety and accuracy of pediatric diagnostic cardiac catheterization. |
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| 投稿者 | Ogawa, Yuki; Yamana, Hayato; Noda, Tatsuya; Kishimoto, Miwa; Yoshihara, Shingo; Kanaoka, Koshiro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Kawaguchi, Masahiko; Imamura, Tomoaki |
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| 組織名 | Department of Public Health, Health Management and Policy, Nara Medical;University, Nara 634-8521, Japan.;Department of Anesthesiology, Nara Medical University, Nara 634-8521, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo 113-0033, Japan.;Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo 103-8668,;Japan.;Regional Healthcare Planning Division, Health Policy Bureau, Ministry of Health,;Labour and Welfare, Tokyo 100-8916, Japan.;Department of Medical and Health Information Management, National Cerebral and;Cardiovascular Center, Osaka 564-8565, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo 113-0033, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School, Tokyo 113-8510, Japan. |
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