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• W4387477411 abstract "Introduction Congenital heart disease (CHD) constitute about 50% of all congenital abnormalities and are one of the main cause of death in the first year of life. In live born there are 8-14 children with CHD in 1000 newborn. Surgery for CHD carries high risk of morbidity and mortality. Perioperative period (especially when critical CHD in newborn are corrected) is often accompanied by multiple organ dysfunction syndrome (MODS) and mortality. Methods We conducted a retrospective research of laboratory and clinical data of 891 pediatric patients with CHD (from 1 day to 18 years of life) treated in our clinic from 2019 to 2022. Results There were 637 patients operated with the use of cardiopulmonary bypass and 254 patients treated without bypass. Age and weight were different in groups with and without bypass. Mortality in bypass group was 4% (26 patients) and 1.9% (5 patients) in group without bypass. Bypass use was not a significant mortality factor (p=0.5). Bypass time was significantly longer in the deceased group (113.5 [53.7;189] vs 64 [43.5;96]). Mortality correlated with bypass time (AUC – 0.76, optimal threshold– 149 minutes; Se% - 56%; Sp% - 93%; p=0.0006). Patients with cyanotic CHD constituted 83.9% of the deceased patients (26 from 31). Odds ratio for cyanotic CHD is 10.2 [95%CI 3.9;26.3; p<0.0001]. Of the deceased patients 23 (74.2%) were newborn with critical CHD. Odds ratio of mortality for critical CHD is 13.8 [95%CI 4.27;44.9;p<0.0001]. We found statistically significant differences between deceased and surviving patients in ventilation time (1 [1;5] vs 1 [1;3] days; p<0.01) and ICU stay (3 [1;7 vs 1 [1;4] days; p<0.01]. Weight between dead patients and survivors was significantly different: 3.5 [2.9;3.7] vs 6.8 [3.7;15] kg. Severe comorbidity was present in 42.3% (11 patients) in deceased patients group and in 25.5% of the survivors. Odds ratio for severe comorbidity is 2.7 [95%CI 1.2;6.2;p<0.015]. Perioperative incidents were present in 23 (88%) patients in deceased group and in 187 (30%) of the survivors. Odds ratio is 15.9 [95%CI 4.8;52;p<0.0001;NNT=-9.7]. Discussion Overall, the data of our research can help to better understand factors that influence postoperative course in children after congenital heart surgery. Surgery in critical CHD is associated with higher mortality risk. Moreover, most of the deceased patients had cyanotic CHD and 74.2% of them had critical CHD. Main mortality predictors were: severe comorbidity, perioperative incidents. Bypass time, ischemic time and cyanotic CHD were statistically significant mortality predictors." @default.
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• W4387477411 date "2023-10-01" @default.
• W4387477411 modified "2023-10-16" @default.
• W4387477411 title "MORBIDITY AND MORTALITY RISK STRATIFICATION IN PATIENTS WITH CONGENITAL HEART DISEASE AFTER CORRECTIVE SURGERY" @default.
• W4387477411 doi "https://doi.org/10.1053/j.jvca.2023.08.114" @default.
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