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Higher mortality among unscreened children

15.01.2009
The study shows that infants that left the maternity ward with undiagnosed heart disease evinced much higher mortality than those who were diagnosed before discharge: 18 percent versus 0.9 percent when comparing children who were not premature or were lacking a functioning left ventricle.

No children died at home with undiagnosed heart disease in the Western Götaland region during the study period, compared with five deaths in the home in the regions under comparison.

The assessment of costs showed that screening is cost-neutral when introduced. All that is needed is a machine with a one-off outlay of about SEK 12,000 (~$1,500) per delivery unit as well as the time, roughly five minutes per infant, it takes for a midwife to perform the screening.

Since the method would entail a probable decrease in neurological damage cause by circulation collapse, and less need for pre-operative intensive care, this screening is cost-effective in the long term.

The prestigious British Medical Journal, which is publishing the study, is also including an editorial commentary by Professor Keith Barrington, Montreal, Canada. He points out that, on the basis of the evidence from this study, routine pulse oximetry screening is a low-risk and low-cost strategy to enhance the detection of critical congenital heart diseases, and that its “introduction should be seriously considered in all countries with access to pediatric heart surgery.”

The screening study constitutes a dissertation project for Anne De-Wahl Granelli, directed by the professor of pediatric cardiology, Ingegerd Östman-Smith, Department of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, and Queen Silvia Hospital for Children and Adolescents.

Ulrika Lundin | alfa
Further information:
http://www.bmj.com/cgi/content/full/338/jan08_2/a3037

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