Reducing Routine Cardiology Evaluation Prior to Initiating Propranolol for Infantile Hemangiomas.
Document Type
Article
Publication Date
11-2025
Identifier
DOI: 10.1002/ohn.70014
Abstract
OBJECTIVE: Determine if all patients with infantile hemangioma (IH) should undergo cardiology evaluation prior to initiating propranolol therapy or if only select patients should undergo cardiology evaluation, as indicated by a Propranolol Screening Checklist (PSC).
METHODS: Retrospective review of 806 IH patients treated with propranolol between 2008 and 2018 at a single tertiary center. Statistical process control methods were used to compare the cardiology recommendations between the pre-PSC and post-PSC populations and there was special cause variation after implementation of the checklist.
RESULTS: There were 527 (73.1%) patients referred for cardiology evaluation prior to propranolol initiation for IH before implementation of the PSC compared to 10 (11.5%) patients referred after PSC implementation (P < .001). There was less testing obtained from patients prior to initiating therapy, like echocardiograms and EKGs. No patients were prevented from initiating therapy throughout the time studied.
DISCUSSION: Cardiology referral prior to initiating propranolol therapy for IH is unnecessary in otherwise healthy infants without concerning signs or symptoms.
IMPLICATIONS FOR PRACTICE: Propranolol therapy can be instituted safely in most IH patients after screening for the need for cardiology referral. This improves efficiency for families and institutions with high complexity patients. This may avoid the long wait times for specialist care which delays this time-sensitive intervention.
Journal Title
Otolaryngology and head and neck surgery
Volume
173
Issue
5
First Page
1291
Last Page
1296
MeSH Keywords
Humans; Propranolol; Retrospective Studies; Infant; Female; Male; Hemangioma; Checklist; Referral and Consultation; Adrenergic beta-Antagonists; Infant, Newborn; Skin Neoplasms
PubMed ID
40891637
Keywords
infantile hemangioma; patient safety; quality improvement; vascular anomaly
Recommended Citation
Champaloux EP, Epstein S, Bull C, et al. Reducing Routine Cardiology Evaluation Prior to Initiating Propranolol for Infantile Hemangiomas. Otolaryngol Head Neck Surg. 2025;173(5):1291-1296. doi:10.1002/ohn.70014
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