Related Experiment Video
Updated: May 7, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Prospective evaluation of acute neurological events after paediatric cardiac surgery
Olivia Frost1,2, Deborah Ridout3, Warren Rodrigues4,5
1Institute of Cardiovascular Science, University College London, London, UK.
Insights
Acute neurological events after pediatric cardiac surgery are rare but linked to longer hospital stays and poorer survival. Risk factors include complex congenital heart disease (CHD), longer operations, and urgent surgery.
Area of Science:
- Pediatric Cardiology
- Neurology
- Cardiac Surgery
Background:
- Children with congenital heart disease (CHD) face increased risks of neurodevelopmental issues.
- The specific impact of perioperative acute neurological events in this population is not well understood.
Purpose of the Study:
- To determine the incidence of acute neurological events in UK pediatric cardiac surgery patients.
- To identify risk factors associated with these events.
- To evaluate the impact of acute neurological events on early postoperative outcomes.
Main Methods:
- A prospective analysis of 3090 consecutive pediatric cardiac surgeries from October 2015 to June 2017 across 5 UK centers.
- Primary outcome: incidence of acute neurological events.
- Secondary outcomes: 6-month survival and postoperative length of stay.
- Logistic regression was used to identify risk factors.
Main Results:
- The incidence of acute neurological events was 2.1% (66 out of 3090 surgeries).
- Independent risk factors included complex CHD (OR 1.9), longer operation times (OR 2.7), and urgent surgery (OR 3.4).
- Acute neurological events were associated with significantly prolonged hospital stay (35 vs. 9 days) and reduced 6-month survival (OR 13.0).
Conclusions:
- Acute neurological events after pediatric cardiac surgery are infrequent but significant.
- These events are linked to poorer outcomes, including prolonged hospitalization and decreased survival.
- Monitoring acute neurological events is valuable for quality assurance in pediatric cardiac surgery.
Objectives:
Children with CHD are at heightened risk of neurodevelopmental problems; however, the contribution of acute neurological events specifically linked to the perioperative period is unclear.
Aims:
This secondary analysis aimed to quantify the incidence of acute neurological events in a UK paediatric cardiac surgery population, identify risk factors, and assess how acute neurological events impacted the early post-operative pathway.
Methods:
Post-operative data were collected prospectively on 3090 consecutive cardiac surgeries between October 2015 and June 2017 in 5 centres. The primary outcome of analysis was acute neurological event, with secondary outcomes of 6-month survival and post-operative length of stay. Patient and procedure-related variables were described, and risk factors were statistically explored with logistic regression.
Results:
Incidence of acute neurological events after paediatric cardiac surgery in our population occurred in 66 of 3090 (2.1%) consecutive cardiac operations. 52 events occurred with other morbidities including renal failure (21), re-operation (20), cardiac arrest (20), and extracorporeal life support (18). Independent risk factors for occurrence of acute neurological events were CHD complexity 1.9 (1.1-3.2), p = 0.025, longer operation times 2.7 (1.6-4.8), p < 0.0001, and urgent surgery 3.4 (1.8-6.3), p < 0.0001. Unadjusted comparison found that acute neurological event was linked to prolonged post-operative hospital stay (median 35 versus 9 days) and poorer 6-month survival (OR 13.0, 95% CI 7.2-23.8).
Conclusion:
Ascertainment of acute neurological events relates to local measurement policies and was rare in our population. The occurrence of acute neurological events remains a suitable post-operative metric to follow for quality assurance purposes.
