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Intermediate survival in neonates with aortic atresia: A multi-institutional study  Marshall L. Jacobs, MD, Eugene H. Blackstone, MD, Leonard L. Bailey,

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Presentation on theme: "Intermediate survival in neonates with aortic atresia: A multi-institutional study  Marshall L. Jacobs, MD, Eugene H. Blackstone, MD, Leonard L. Bailey,"— Presentation transcript:

1 Intermediate survival in neonates with aortic atresia: A multi-institutional study 
Marshall L. Jacobs, MD, Eugene H. Blackstone, MD, Leonard L. Bailey, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 116, Issue 3, Pages (September 1998) DOI: /S (98)70008-X Copyright © 1998 Mosby, Inc. Terms and Conditions

2 Fig. 1 Non-risk-adjusted survival and hazard function for death for all 323 patients in the study. A, Survival after entry (at time zero). Each circle represents an actual death, positioned at the time of death along the horizonal axis and actuarially along the vertical axis. The vertical bars depict ± 1 standard error. The numbers indicate the number of patients remaining at risk at the time of the estimate. The solid line is the parametric estimate of survival, and the dashed lines enclose the 70% confidence intervals. B, Hazard function for death. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

3 Fig. 2 Schematic diagram of the treatment pathway and fate of the 323 patients after initial protocol assignment. SVC-PA, Superior vena cava–pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

4 Fig. 3 Non-risk-adjusted survival for patients treated at the 4 low-risk institutions. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

5 Fig. 4 Non-risk-adjusted survival and hazard function for patients (n = 253) initially entered in the staged reconstructive surgery protocol. A, Survival after entry (at time zero). B, Hazard function for death. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

6 Fig. 5 Competing Risks Analysis for patients in the staged reconstructive surgery protocol (n = 253). The number of patients (expressed as a percent of total) in each of 5 categories across the time of follow-up is depicted. All patients begin alive, awaiting definitive repair. Thereafter, patients migrate to death, the Fontan operation, heart transplantation, and 2-ventricle repair according to the respective hazard functions operating on those remaining alive, awaiting definitive repair. At every point in time, the number of patients in all categories adds to 100% (so-called conservation of patients). Symbols represent each event, positioned on the vertical axis by multiple decrement analysis. The solid curves represent mathematical estimates of the accumulative effect of the 4 hazard functions operating on the original group of patients. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

7 Fig. 6 Non-risk-adjusted survival and hazard function for death for patients (n = 49) initially entered in the heart transplant protocol. A, Survival after entry (at time zero). B, Hazard function for death. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

8 Fig. 7 Competing Risks Analysis for patients (n = 49) initially entered into the heart transplant protocol. The number of patients (expressed as a percent of total) in each of 4 categories across the time of follow-up is depicted. All patients begin alive, awaiting transplantation. Thereafter, patients migrate to heart transplantation, death awaiting transplantation, and Norwood operations according to the respective hazard function. The depiction is otherwise as in Fig. 5. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

9 Fig. 8 Non-risk-adjusted survival for patients awaiting transplantation in the heart transplantation protocol, and for patients in the no surgical treatment protocol. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

10 Fig. 9 Actuarial (life-table) survival of patients stratified according to the 3 treatment protocols. Each symbol represents an actual death, positioned at the time of death along the horizontal axis and actuarially along the vertical axis. The vertical bars depict ± 1 standard error. The numbers indicate the number of patients remaining at risk at the time of estimate. The solid lines are the parametric estimates of survival, and the dashed lines enclose the 70% confidence intervals. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

11 Fig. 10 A, Non-risk-adjusted survival of patients entered into treatment protocols at the 4 low-risk institutions. The 70% confidence intervals converge at a point approximately 1 week after entry and continue to overlap thereafter. B, Survival of patients initially entering either surgical treatment protocol at the 4 low-risk institutions is shown, together with results at the remaining institutions. Patients for whom the nonsurgical protocol was initially designated are excluded from this analysis. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (98)70008-X) Copyright © 1998 Mosby, Inc. Terms and Conditions

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