Unplanned Repeat Echocardiography with Sedation in Children: Patient Risk Factors

Kenan W.D. Stern, Chen Chen, Hillel W. Cohen, Joseph Mahgerefteh, Sarah A. Chambers, Leo Lopez

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Patient selection criteria for echocardiography with sedation in children are not well defined. We attempted to identify predictors of unplanned repeat echocardiography with sedation. This was a single-center, case–control study of echocardiograms performed in children aged 1–36 months. Cases underwent unplanned repeat examinations with sedation, while controls did not. Patient variables and study indications were compared. Logistic regression identified the most significant predictors. Cases (n = 104, median time to repeat echocardiogram 17 days, median age 12.9 months) were older than controls (n = 212, median age 5.0 months, P < 0.001). Significantly more cases than controls had structural cardiac disease (64 vs. 23 %) and anatomic complexity ≥moderate (38 vs. 5 %, P < 0.001 for both). Cases more often had Kawasaki disease (11 vs. 2 %), and controls more often had murmur (56 vs. 11 %, P < 0.001 for both). Logistic regression identified age 6 months to <2 years (OR 3.26, 95 % CI 1.70–6.28, P < 0.001), Kawasaki disease (OR 5.20, 95 % CI 1.46–18.50, P = 0.01), and known pre-echocardiogram anatomic complexity ≥moderate (OR 3.99, 95 % CI 1.64–9.66, P = 0.002) as significant risk factors. An indication for murmur was protective (OR 0.32, 95 % CI 0.13–0.76, P = 0.01). We identified several risk factors for unplanned repeat echocardiography with sedation in children, including age 6 months to <2 years, higher anatomic complexity, and Kawasaki disease. Murmur was a protective factor. These results may help pediatric echocardiography laboratories establish criteria for sedation.

Original languageEnglish (US)
Pages (from-to)1057-1063
Number of pages7
JournalPediatric Cardiology
Volume37
Issue number6
DOIs
StatePublished - Aug 1 2016

Keywords

  • Diagnostic error
  • Echocardiography
  • Pediatric and congenital heart disease
  • Procedural sedation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Stern, K. W. D., Chen, C., Cohen, H. W., Mahgerefteh, J., Chambers, S. A., & Lopez, L. (2016). Unplanned Repeat Echocardiography with Sedation in Children: Patient Risk Factors. Pediatric Cardiology, 37(6), 1057-1063. https://doi.org/10.1007/s00246-016-1391-x