[Prognostic factors associated with postoperative morbidity in children with isolated ventricular septal defect]

Area of Science:

• Pediatric Cardiology
• Congenital Heart Surgery

Background:

• Isolated ventricular septal defect (VSD) is a prevalent global congenital heart condition.
• Identifying prognostic factors for postoperative morbidity in isolated VSD patients is crucial for improving outcomes.
• Previous studies have not fully elucidated these factors at the Hospital de Pediatría del Centro Médico Nacional Siglo XXI.

Purpose of the Study:

• To identify prognostic factors associated with postoperative morbidity and prolonged intensive care unit (ICU) stay in patients undergoing isolated VSD closure.
• To analyze the impact of specific clinical and demographic factors on patient recovery.
• To provide data for optimizing perioperative management strategies.

Main Methods:

• A retrospective cohort study analyzed data from January 1, 2009, to December 31, 2013.
• Statistical analyses included chi-square test, Mann Whitney U test, and linear regression.
• Relative risks (RR) and 95% confidence intervals (95% CI) were calculated to assess associations.

Main Results:

• The study included 64 patients with isolated VSD; 34.3% had Down syndrome.
• Perimembranous and subaortic lesions were present in 70% of cases.
• Factors associated with increased morbidity and prolonged ICU stay were lactate > 3 mmol/L post-extracorporeal circulation (p=0.02) and Down syndrome (p=0.02).

Conclusions:

• Higher preoperative functional class correlated with longer hospital stay, ICU duration, and mechanical ventilation hours.
• Down syndrome was significantly associated with increased postoperative complications.
• Lactate levels at the end of extracorporeal circulation are a key indicator for predicting adverse outcomes.