Variation in Chest Tube Duration and Length of Stay Across Centers in the Pediatric Acute Care Cardiology Collaborative (PAC3) and Pediatric Cardiac Critical Care Consortium (PC4)

Background: Most children undergoing congenital heart surgery have chest tubes (CT) placed intraoperatively. Center variation in practices related to timing of removal and impact on outcomes has not been studied to date. In this joint PAC3-PC4 analysis we evaluated variation in CT practices and outcomes across sites. Methods: Patients undergoing any of the 10 “benchmark” operations (VSD, Tetralogy of Fallot, Fontan, atrioventricular canal, truncus arteriosus, off-bypass coarctation, Glenn/Hemi-Fontan, arterial switch, arterial switch/VSD, and Norwood) from July 2017-January 2018 at participating PAC3 sites were included. Demographics, operative, and LOS data from PC4 were merged with data on CT output, duration, and reinsertion from PAC3. Practices and outcomes were compared across sites and at one “model” site vs. others using standard univariate statistics. Results: 488 patients (8 centers) were included. Median CT duration varied significantly across sites for 7/10 benchmark operations (Figure A). One ...