XXXX in adults: Is it time for a paradigm shift?

@entity1 @entity1757 @entity439 @entity337 @entity884
BACKGROUND: To determine the risk and predictors of progression of @entity337 ( @entity337 ) and other adverse events (AE) in adults with supracristal @entity1757 ( @entity1757 ). METHODS: Retrospective observational study of 62 adults with @entity1757 followed at the Mayo Clinic from 1994 to 2013. Freedom from @entity337 progression was compared by age and racial groups (Asian vs non-Asian). Predictors of @entity337 progression were determined using Cox proportional hazard model. Composite AE endpoint was defined as @entity337 progression, @entity884 , @entity439 ( @entity439 ), and rupture of @entity439 . Risk of AE was compared between group 1 (no surgical intervention) and group 2 (surgical intervention). RESULTS: Sixty-two @entity1 aged 47(SD 12) years were followed for 13 (SD 5) years. Group 1=42/62 and group=20/62. Endpoint of @entity337 progression and @entity439 occurred in 13% and 20% respectively. Freedom from @entity337 progression for the entire cohort was 88%, 86% and 86% at 5, 10 and 15years respectively. Risk of @entity337 progression was significantly lower in @entity1 (aged  <=40years, p=0.008) but similar between Asians and non-Asians (p=0.57). Age  <=40years was an independent predictor of @entity337 progression (hazard ratio [HR] 3.5, 95% CI 2.3-5.4, p=0.001). Composite AE endpoint occurred in 33% and 40% of group1 and 2 cohorts respectively, p=0.69. CONCLUSION: Adults with @entity1757 are at lower risk for @entity337 progression but higher risk for @entity439 formation compared to historical pediatric cohorts. Younger age was a predictor of @entity337 progression. Surgical intervention had no protective effect on complication rate.
