Publications by authors named "Alfred D'Ottavio"

Background: Sociodemographic factors influence outcomes in children with congenital heart disease (CHD). We predict an association between measures of social isolation and outcomes in infants with complex CHD. These measures, racial (RI) and educational (EI) isolation range from 0 to 1, with 0 being no isolation and 1 being fully isolated within a specific population.

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Article Synopsis
  • The Society of Thoracic Surgeons Congenital Heart Surgery Database is a major global resource on congenital heart surgeries, but lacks data on complications, comorbidities, and long-term patient outcomes.
  • This study assessed how effectively this database could be linked to hospital electronic health records in North Carolina and Georgia, using both indirect and direct identifiers.
  • Results showed that indirect linkage matched 79% of admissions, while direct methods achieved up to 99.5% success, demonstrating the effectiveness of integrating surgical data with electronic records for better patient care insights.
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Background: Despite advances in treatment and survival, individuals with congenital heart defects (CHD) have a higher risk of heart failure (HF) compared to the general population.

Objective: To evaluate comorbidities associated with HF in patients with CHD with a goal of identifying potentially modifiable risk factors that may reduce HF-associated morbidity and mortality.

Methods: Five surveillance sites in the United States linked population-based healthcare data and vital records.

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Background: Socioeconomic factors may lead to a disproportionate impact on health care usage and death among individuals with congenital heart defects (CHD) by race, ethnicity, and socioeconomic factors. How neighborhood poverty affects racial and ethnic disparities in health care usage and death among individuals with CHD across the life span is not well described.

Methods And Results: Individuals aged 1 to 64 years, with at least 1 CHD-related () code were identified from health care encounters between January 1, 2011, and December 31, 2013, from 4 US sites.

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Adults with congenital heart disease (CHD) benefit from cardiology follow-up at recommended intervals of ≤ 2 years. However, benefit for children is less clear given limited studies and unclear current guidelines. We hypothesize there are identifiable risks for gaps in cardiology follow-up in children with CHD and that gaps in follow-up are associated with differences in healthcare utilization.

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The objective of this study was to assess the relationship of prenatal diagnosis of critical congenital heart disease (CHD) to preoperative and postoperative patient findings. Retrospective analysis of neonates with critical CHD who underwent cardiothoracic surgery at one of four centers in North Carolina between 2008 and 2013. Surgical data collected by sites for submission to the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) and the North Carolina CHD Lifespan Database were queried.

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Children with congenital heart defects (CHDs) are at risk for poor academic performance. The degree to which receipt of health care services is associated with adverse academic outcomes is not known. We examined the association between episodes of cardiac care and third-grade performance in children with CHD.

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Article Synopsis
  • - The study analyzed follow-up care for adults with congenital heart disease (CHD) in North Carolina, revealing that 39% of patients did not receive the recommended follow-up within two years after their initial healthcare encounter.
  • - Among the 2822 patients studied, those with severe CHD had better follow-up rates (72%) compared to those with less severe conditions (55%), while follow-up was notably lower among Black patients (56%) than White patients (64%).
  • - Younger age, having non-severe CHD, and being from a minority background were identified as factors that increased the likelihood of inadequate follow-up, suggesting a need for targeted health interventions to improve care retention in these groups.
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Background The Centers for Disease Control and Prevention's Surveillance of Congenital Heart Defects Across the Lifespan project uses large clinical and administrative databases at sites throughout the United States to understand population-based congenital heart defect (CHD) epidemiology and outcomes. These individual databases are also relied upon for accurate coding of CHD to estimate population prevalence. Methods and Results This validation project assessed a sample of 774 cases from 4 surveillance sites to determine the positive predictive value (PPV) for identifying a true CHD case and classifying CHD anatomic group accurately based on 57 codes.

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Sudden infant death syndrome (SIDS) is the sudden, unexplained death of infants <1 year old. SIDS remains a leading cause of death in US infants. We aim to identify associations between SIDS and race/ethnicity, birth weight/gestational age, and socioeconomic/environmental factors in North Carolina (NC) to help identify infants at risk for SIDS.

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Background: Many individuals born with congenital heart defects (CHD) survive to adulthood. However, population estimates of CHD beyond early childhood are limited in the U.S.

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Article Synopsis
  • * Among 629 patients studied, the median age at death was 64.2 years, with significant differences based on the severity of CHD.
  • * Severe CHD patients often died from cardiovascular-related issues, while those with nonsevere CHD died more frequently from non-cardiac causes like cancer and heart disease.
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