Objective

To determine presence of spatial clustering or dispersion of pre and postnatally detected hypoplastic left heart syndrome (HLHS) and d-transposition of the great arteries (TGA) cases.

Study design

This retrospective study examined all patients with a prenatal or postnatal diagnosis of HLHS or TGA who had an initial visit or hospitalization at our tertiary care center over a 5-year period from 2012 to 2016 (n = 105). Using geographic information systems software, the nearest neighbor ratio (NNR) tool was used to determine whether statistically significant clustering or dispersion occurred.

Results

Geographic clustering was observed among prenatally diagnosed pooled cases of HLHS and TGA and all total cases (NNR = 0.73 and 0.66, respectively), but not postnatally detected cases (NNR = 1.08). Notably, there was significant dispersion of postnatally detected TGA cases (NNR = 1.22) There was no pattern for prenatally detected TGA or HLHS when analyzed individually.

Conclusions

The spatial distribution of HLHS and TGA is not random; these conditions occur in geographic clusters. Clustering of all patients in the study population and dispersion of postnatal diagnosis of TGA represent opportunities for improved delivery of fetal cardiac care.

中文翻译：

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先天性心脏病的地理分布：单一外科中心的经验

客观的

确定出生前后检测到的左心发育不全综合征 (HLHS) 和大动脉 d 转位 (TGA) 病例是否存在空间聚集或分散。

学习规划

这项回顾性研究检查了所有产前或产后诊断为 HLHS 或 TGA 的患者，这些患者在 2012 年至 2016 年的 5 年期间在我们的三级护理中心进行了初次访问或住院治疗（n = 105）。使用地理信息系统软件，使用最近邻比 (NNR) 工具来确定是否发生了统计上显着的聚类或离散。

结果

在产前诊断的 HLHS 和 TGA 合并病例以及所有总病例（分别为 NNR = 0.73 和 0.66）中观察到地理聚类，但在出生后检测到的病例中未观察到（NNR = 1.08）。值得注意的是，产后检测到的 TGA 病例存在显着差异 (NNR = 1.22) 单独分析时，产前检测到的 TGA 或 HLHS 没有模式。

结论

HLHS和TGA的空间分布不是随机的；这些情况发生在地理集群中。研究人群中所有患者的聚集和 TGA 产后诊断的分散代表了改善胎儿心脏护理的机会。