To determine potentially modifiable risk factors for a complicated Glenn procedure (cGP) and whether a cGP predicted adverse neurodevelopmental and functional outcomes. A cGP was defined as post-operative death, heart transplant, extracorporeal life support, Glenn takedown, or prolonged ventilation.

All 169 patients having a Glenn procedure from 2012 to 2017 were included. Neurodevelopmental assessments were performed at age 2 years in consenting survivors (n = 156/159 survivors). The Bayley Scales of Infant and Toddler Development-3rd Edition (Bayley-III) and the Adaptive Behavior Assessment System-2nd Edition (ABAS-II) were administered. Adaptive functional outcomes were determined by the General Adaptive Composite (GAC) score from the ABAS-II. Predictors of outcomes were determined using univariate and multiple variable linear or Cox regressions.

Of patients who had a Glenn procedure, 10/169 (6%) died by 2 years of age and 27/169 (16%) had a cGP. Variables statistically significantly associated with a cGP were the inotrope score on post-operative day 1 (HR 1.04, 95%CI 1.01, 1.06; p = 0.010) and use of inhaled nitric oxide post-operatively (HR 7.31, 95%CI 3.19, 16.76; p < 0.001). A cGP was independently statistically significantly associated with adverse Bayley-III Cognitive (ES −10.60, 95%CI −17.09, −4.11; p = 0.002) and Language (ES −11.43, 95%CI −19.25, −3.60; p = 0.004) scores and adverse GAC score (ES −14.89, 95%CI −22.86, −6.92; p < 0.001).

Higher inotrope score and inhaled nitric oxide used post-operatively were associated with a cGP. A cGP was independently associated with adverse 2-year neurodevelopmental and functional outcomes. Whether early recognition and intervention for risk of a cGP can prevent adverse outcomes warrants study.

确定复杂格伦手术 (cGP) 的潜在可改变风险因素，以及 cGP 是否可以预测不良的神经发育和功能结果。cGP 的定义是术后死亡、心脏移植、体外生命支持、Glenn 被击倒或长时间通气。

2012 年至 2017 年接受 Glenn 手术的所有 169 名患者均纳入其中。在同意的幸存者（n = 156/159 幸存者）2 岁时进行了神经发育评估。实施婴儿和幼儿发展贝利量表第三版（ Bayley-III）和适应性行为评估系统第二版（ABAS-II）。适应性功能结果由 ABAS-II 的一般适应性综合 (GAC) 评分确定。使用单变量和多变量线性或 Cox 回归确定结果的预测因子。

在接受 Glenn 手术的患者中，10/169 (6%) 的患者在 2 岁时死亡，27/169 (16%) 的患者接受了 cGP。与 cGP 统计显着相关的变量是术后第 1 天的正性肌力评分（HR 1.04，95%CI 1.01，1.06；p = 0.010）和术后吸入一氧化氮的使用（HR 7.31，95%CI 3.19， 16.76；p < 0.001）。cGP 与不良 Bayley-III 认知（ES -10.60，95%CI -17.09，-4.11；p = 0.002）和语言（ES -11.43，95%CI -19.25，-3.60；p = 0.004）独立显着相关。 ) 分数和不良 GAC 分数（ES -14.89，95%CI -22.86，-6.92；p < 0.001）。

较高的正性肌力评分和术后使用的吸入一氧化氮与 cGP 相关。cGP 与 2 年神经发育和功能不良结果独立相关。早期识别和干预 cGP 风险是否可以预防不良后果值得研究。