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Original Article--Risk Factors for Neurological Complications and Short-term Outcomes After Pediatric Heart Surgery:
Muhammad Shahzad1, Yasser A Alheraish1, Bushra Algethami1
1Department of Critical Care, King Faisal Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
Insights
Pediatric heart surgery patients with central nervous system (CNS) insult experienced worse outcomes. Previous CNS insult was a significant risk factor for post-surgery CNS insult, leading to increased mortality and longer hospital stays.
Area of Science:
- Pediatric Cardiology
- Pediatric Neurology
- Critical Care Medicine
Background:
- Neurological complications are a significant concern following pediatric heart surgery.
- Identifying risk factors for these complications is crucial for improving patient outcomes.
Purpose of the Study:
- To assess risk factors for neurological complications after pediatric heart surgery.
- To evaluate the association between neurological complications and short-term outcomes.
Main Methods:
- A cross-sectional study analyzed data from children under 15 who underwent open-heart surgery and had a CT scan.
- Data included demographics, surgical details, and neurological outcomes (CNS insult, seizures).
- Statistical analysis identified risk factors and associations with outcomes like mortality and length of stay.
Main Results:
- Of 208 children who had CT scans, 2.81% experienced neurological complications, most commonly seizures (7.2%).
- Previous CNS insult was significantly associated with post-surgery CNS insult (p=0.001).
- Children with CNS insult had significantly longer ICU and hospital stays and higher mortality rates.
Conclusions:
- Seizures are the most frequent neurological complication post-pediatric cardiac surgery.
- Central nervous system insult is linked to adverse outcomes, including increased mortality and prolonged hospitalization.
Objective:
To assess the risk factors associated with neurological complications and poor short-term outcomes following pediatric heart surgery.
Methodology:
A cross-sectional study was conducted in a cardiac intensive care unit between June 2019 and June 2022. The data of all children less than 15 years old who underwent open-heart surgery and had CT brain were extracted from hospital records. The primary outcome was the incidence of CNS insult, and secondary outcomes included death after surgery, length of stay in ICU and hospital. Data analysis was performed using SPSS version 23, and a p-value less than or equal to 0.05 was considered statistically significant.
Results:
Total 1850 surgeries were performed in the specified period of time. The study included 208 children who had CT Brain, with a median age of 5 months. 2.81 % children had neurological complications, with 25 % of patients who had CT brain. The most common neurological complication was seizure (7.2 %). There were no significant differences observed between CNS insult and age, gender, syndrome, or prematurity (p > 0.05), except for a significant association between previous CNS insult and CNS insult after surgery (p = 0.001). Children with CNS insult had significantly higher ICU and hospital length of stay, mortality after surgery, and mortality within 2 weeks of surgery (p ≤ 0.05).
Conclusion:
Seizure was most common neurological manifestation after cardiac surgeries in children. CNS insult after surgery was associated with worse outcomes, including longer hospital stays and increased mortality.
