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Updated: Jan 19, 2026
A Simplified Model for Heterotopic Heart Valve Transplantation in Rodents
Published on: September 21, 2021
Risk stratification models for congenital heart surgery in children: Comparative single-center study
Sara Bobillo-Perez1,2, Joan Sanchez-de-Toledo3,4, Susana Segura2
1Disorders of Immunity and Respiration of the Pediatric Critical Patient Research Group, Institut Recerca Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
Objective:
Three scores have been proposed to stratify the risk of mortality for each cardiac surgical procedure: The RACHS-1, the Aristotle Basic Complexity (ABC), and the STS-EACTS complexity scoring model. The aim was to compare the ability to predict mortality and morbidity of the three scores applied to a specific population.
Design:
Retrospective, descriptive study.
Setting:
Pediatric and neonatal intensive care units in a referral hospital.
Patients:
Children under 18 years admitted to the intensive care unit after surgery.
Interventions:
None.
Outcome Measures:
Demographic, clinical, and surgical data were assessed. Morbidity was considered as prolonged length of stay (LOS > 75 percentile), high respiratory (>72 hours of mechanical ventilation), and high hemodynamic support (inotropic support >20).
Results:
One thousand and thirty-seven patients were included, in which 205 were newborns (18%). The category 2 was the most frequent in the three scores: In RACHS-1, ABC, 44.9%, and STS-EACTS, 40.8%. Newborns presented significant higher categories. Children required cardiopulmonary bypass in more occasions (P < .001) but the times of bypass and aortic cross-clamp were significantly higher in newborns (P < .001 and P = .016). Thirty-two patients died (2.8%). A quarter of patients had a prolonged LOS, 17%, a high respiratory support, and 7.1%, a high hemodynamic support. RACHS-1 (AUC 0.760) and STS-EACTS (AUC 0.763) were more powerful for predicting mortality and STS-EACTS for predicting prolonged LOS (AUC 0.733) and the need for high respiratory support (AUC 0.742).
Conclusions:
STS-EACTS seems to stratify better risk of mortality, prolonged LOS, and need for respiratory support after surgery.
