Factors Associated with Prolonged Recovery after the Arterial Switch Operation for Transposition of the Great Arteries in Infants

This study aimed specifically to identify the predictors of prolonged
recovery after the arterial switch operation for transposition of the
great arteries in infants. The clinical records of all infants admitted
to the surgical intensive care unit (SICU) between January 2000 and
March 2011 after an arterial switch operation were retrospectively
reviewed. The cohort was divided into a prolonged recovery group that
included all patients who exceeded the 75th percentile for duration of
SICU stay and a standard recovery group that included all the remaining
patients. Of the 102 patients in the final analysis, 31 experienced
prolonged recovery. The median SICU stay was 18 days (range, 14-58 days)
for the patients in the prolonged recovery group and only 8 days
(range, 5-13 days) for the patients in the standard recovery group.
After univariate analysis, a stepwise logistic regression model analysis
was used to compare the demographic data as well as the pre-, intra-,
and postoperative variables between the two groups. Of all the variables
analyzed, high postbypass serum lactate level [odds ratio (OR), 2.610;
95 % confidence interval (CI), 1.464-4.653; p = 0.039], need for larger
volume of resuscitation fluid (OR, 3.154; 95 % CI, 1.751-5.682; p =
0.018), and noninfectious pulmonary complication (OR, 2.844; 95 % CI,
1.508-5.363; p = 0.025) were identified as independent risk factors for
prolonged recovery among infants undergoing an arterial switch operation
for transposition of the great arteries.