260 - Incidence of Neonatal Dysrhythmias and Impact on Outcomes: Analysis of the National Database

Neonatal cardiac dysrhythmias have been increasingly diagnosed. However, their clinical correlates and impact on outcomes are not well described.

Objective:

To assess demographics and clinical factors associated with neonatal dysrhythmias and describe their impact on length of hospital stay and mortality.

Design/Methods:

We used the deidentified National Inpatient Sample produced by the federal Health Cost and Utilization Project. Sample included neonates born in the years 2016-2018. Different types of cardiac dysrhythmias were identified using International Classification of Diseases codes version 10. We classified dysrhythmias into the following subtypes: bradyarrhythmia including all types of heart block (HB), supraventricular tachyarrhythmias including Wolf-Parkinson-White Syndrome (WPW), supraventricular tachycardia (SVT), and other atrial tachycardias (AT), ventricular tachycardias (VT), and ectopic beats (EB). We described demographic, perinatal, and clinical factors associated with each subtype. To examine the impact of dysrhythmias on mortality and length of stay, we excluded newborns with chromosomal disorders, common genetic syndromes, infants with central nervous system, lung anomalies, structural congenital heart diseases, congenital diaphragmatic hernia, abdominal wall defects, and renal dysplasia. We used logistic regression analysis to control for factors that contribute to the length of stay or mortality.

Results:

There were 11,597,756 newborns in the sample; 15,795 (0.14%) of them had at least one type of dysrhythmia. The distribution of different types of dysrhythmias, demographic, perinatal and clinical characteristics of each group of patients are described in table 1. Length of stay (LOS) was significantly longer with most types of dysrhythmias except ectopic beats and mortality was significantly higher in atrial and ventricular tachycardias compared to those with no dysrhythmia (aOR: 14.2; CI: 5.5-36.6; and aOR: 157; CI: 62-402, respectively), table 2.

Conclusion(s):

Neonatal dysrhythmias are common findings in preterm, low birth weight infants and those of male sex (except HB and EB). Although EB is the most common form of dysrhythmias, it was not associated with significant mortality or prolonged LOS. Mortality was significantly associated with VT followed by AT and HB. All types of dysrhythmias were associated with prolonged LOS.