Delayed diagnosis in children with congenital heart disease: a mixed-method study

Murni, Indah K. and Wirawan, Muhammad Taufik and Patmasari, Linda and Sativa, Esta R. and Arafuri, Nadya and Nugroho, Sasmito and Noormanto, Noormanto (2021) Delayed diagnosis in children with congenital heart disease: a mixed-method study. BMC Pediatrics, 21 (1). ISSN 14712431

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Abstract

Background: Delayed diagnosis of congenital heart disease (CHD) causes significant morbidity and mortality. We aimed to determine the proportion of delayed diagnosis of CHD and factors related to the delayed diagnosis. Methods: A prospective cohort study with mixed-methods was conducted in Dr. Sardjito Hospital, Yogyakarta, Indonesia. Patients aged < 18 years with newly diagnosed CHD and echocardiography confirmed CHD were included. Data were recorded from medical records and interviews from direct caregivers. Logistic regression was used to identify independent factors associated with the delay. Results: A total of 838 patients were included with median age of 2.9 years (0–17.7 years), with female predominance (54.2, n = 454). The proportions of delayed diagnosis were 60.8 (510), 54.9 (373) and 86.2 (137) in all children with CHD, acyanotic and cyanotic CHD, respectively. Delayed diagnosis by doctor was the most common cause, followed by delayed diagnosis related to midwifery care, financial, referral/follow-up, and social factors. In multivariate analysis, cyanotic CHD, residence outside the city, non-syndromic, low family income, normal labour and at term gestation at birth were independently associated with the delay. At diagnosis, heart failure and pulmonary hypertension occurred in 414 (49.4) and 132 (15.8) children with CHD, respectively. Conclusions: Six in ten children with CHD were diagnosed with significant delay. Delayed diagnosis by doctor was the most common cause. Children with cyanotic CHD, residence outside the city, non-syndromic, low family income, normal labour and at term gestation at birth were independently associated with the delay. Comorbid complications in delayed diagnosis of CHD were prevalent. © 2021, The Author(s).

Item Type: Article
Additional Information: Cited by: 25; All Open Access, Gold Open Access, Green Open Access
Uncontrolled Keywords: Adolescent; Child; Child, Preschool; Cyanosis; Delayed Diagnosis; Female; Heart Defects, Congenital; Humans; Indonesia; Infant, Newborn; Prospective Studies; adolescent; adult; Article; caregiver; child; childbirth; cohort analysis; comorbidity; congenital heart disease; controlled study; cyanosis; delayed diagnosis; echocardiography; family income; female; financial management; follow up; gestational age; heart failure; human; Indonesia; infant; interview; labor; lowest income group; major clinical study; male; medical examination; medical record; midwife; multimethod study; newborn; patient referral; prospective study; pulmonary hypertension; residential home; risk assessment; risk factor; sex difference; social aspect; urban area; young adult; congenital heart malformation; cyanosis; preschool child
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine, Public Health and Nursing > Biomedical Sciences
Depositing User: Sri JUNANDI
Date Deposited: 27 Sep 2024 09:14
Last Modified: 27 Sep 2024 09:14
URI: https://ir.lib.ugm.ac.id/id/eprint/4512

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