Abstract 14450: Standardized Clinical Assessment and Management Plan (SCAMP) on Growth in Infants With Congenital Heart Disease
Introduction: Growth failure is prevalent among infants with congenital heart disease (CHD). A Standardized Clinical Assessment and Management Plan (SCAMP) was introduced at Boston Children’s Hospital cardiac medical ward to identify patients with growth failure, evaluate relevant contributing conditions, and recommend a management plan including collaboration with nutrition physicians. Our aim was to determine whether SCAMP-enrolled patients had improved growth compared to historical controls.
Methods: SCAMP patients were enrolled July 2013 - June 2014. Historical controls were selected from patients admitted to the same ward June 2010 - June 2011 who would have met eligibility criteria for SCAMP enrollment. Eligible patients: <1 year, diagnosed with CHD, and had growth failure defined by a WHO weight-for-age z-score (WAZ) < -2 or failure to sustain adequate weight gain. Exclusion criteria: contraindication to enteral feeding, diagnosis to explain growth failure, genetic syndrome, awaiting heart transplant, planned intervention within 7 days, age < 14 days. SCAMP-enrolled patients received a nutrition consult and feeding team evaluation, and ORL consult for patients with relevant conditions or symptoms. Nutrition physicians collaborated regularly with cardiologists to guide management of SCAMP patients during hospitalization. Outcome: Change in WAZ from enrollment to most recent weight measurement among patients with at least 6 months of follow-up.
Results: 29 SCAMP patients (62% male, 49% univentricular, 31% unrepaired) and 42 controls (60% male, 26% univentricular, 38% unrepaired); control patients were older at baseline admission weight (146 vs. 117 days, p=0.18), had a higher WAZ (-2.87 ± 0.74 vs. -3.69 ± 1.70, p=0.02), and had longer follow-up time (1312 vs. 579 days, p<0.01). SCAMP patients were more likely to have had catheterizations (p=0.04) before enrollment, and had greater WAZ gain (2.70 ± 1.84 vs. 1.83 ± 1.20, p=0.03) at most recent follow up.
Conclusions: Patients enrolled in a nutrition-focused SCAMP had a greater improvement in WAZ than historical controls. Identification of growth failure and collaboration with nutrition physician experts appeared to improve weight gain among CHD patients experiencing growth failure.
Author Disclosures: R. Gongwer: None. K. Gauvreau: None. S. Huh: None. K. Sztam: None. K. Jenkins: None.
- © 2016 by American Heart Association, Inc.