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A prospective observational study of paediatric cardiac surgery outcomes in a postoperative intensive care unit in
Shahla Roodpeyma1, Manuchehr Hekmat, Maryam Dordkhar
1Department of Paediatric Cardiology and Paediatric Cardiac Surgery, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. roodpeyma_shahla@yahoo.com
Insights
Critically ill infants with cyanotic congenital heart disease face high mortality in the early post-operative period. Prolonged mechanical ventilation is also a significant risk factor for mortality in pediatric cardiology intensive care units.
Area of Science:
- Pediatric Cardiology
- Intensive Care Medicine
- Congenital Heart Disease
Background:
- Paediatric Cardiology Intensive Care Units (ICUs) in developing countries face unique challenges.
- Understanding mortality and its risk factors is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of complications, morbidity, and mortality in a paediatric cardiology ICU.
- To identify risk factors associated with mortality in this patient population.
Main Methods:
- A prospective observational study was conducted at Shahid Modarres Hospital, Tehran, Iran.
- 202 patients were monitored in the Paediatric Cardiology Intensive Care Unit from August 2009 to July 2010.
- Statistical analysis was performed using SPSS 16, with p < 0.05 considered significant.
Main Results:
- The overall mortality rate was 12.37% (25 out of 202 patients).
- Infants, cyanotic congenital heart disease, longer cardiopulmonary bypass, aortic cross-clamp time, and mechanical ventilation duration were associated with mortality.
- Regression analysis identified cyanotic congenital heart disease, longer intubation time, and the early post-operative period as major mortality factors.
Conclusions:
- Critically ill infants with cyanotic congenital heart disease are at high risk of mortality within 24 hours post-operation.
- Prolonged mechanical ventilation is significantly associated with increased mortality in this setting.
Objective:
To evaluate the incidence of complications, morbidity and mortality, and the associated risk factors with mortality at a Paediatric Cardiology Intensiv Care Unit of a developing country.
Methods:
The prospective observational study was conducted at Shahid Modarres Hospital, Tehran, Iran, from August 2009 to July 2010. A total of 202 patients were monitored from the time they entered the Paediatric Cardiology Intensive Care Unit till their final discharge. SPSS 16 was used for statistical analysis and p < or = 0.05 was considered statistically significant.
Results:
Of the total, 107 (53%) were male and 95 (47%) were female. The mean age of the patients was 4.5 +/- 4.9 years (range: 2 days to 18 years). Among the patients 59 (29.2%) had complications and 25 (12.37%) of them died. A total of 177 (87.6%) survived and were discharged. Infants (p = 0.012), cyanotic congenital heart disease (p = 0.002), longer duration of cardiopulmonary bypass (p = 0.027), longer aortic cross-clamp time (p = 0.038), longer mechanical ventilation time (p < 0.006), and early post-operative period (p = 0.05) were associated factors for mortality. According to regression analysis, cyanotic congenital heart disease, longer intubation time, and early post-operative period were major factors for mortality (p = 0.01, p < 0.001, and p = 0.001) respectively.
Conclusion:
Critically ill cyanotic young infants in the first 24 hours after operation experienced high mortality. Prolonged mechanical ventilation was also associated with high mortality.
