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Published on: July 18, 2014
Comparative analysis of cardiac surgery outcomes in patients with congenital heart defects: a retrospective cohort
Ahmed Yahya Abdullah Alansi1, Talal Ali Hussein Alqalah2,3
1Cardiac center, Al-Thawra Modern General Hospital, Sana'a City, Yemen.
Insights
Pediatric cardiac surgery in Yemen shows comparable mortality between local and foreign teams. However, local teams face higher complication rates and longer hospital stays, indicating a need for improved training and resources for congenital heart defect surgeries.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery Outcomes
- Global Health
Background:
- Congenital heart defects (CHDs) are a leading cause of pediatric illness and death in Yemen.
- Understanding surgical outcomes is crucial for improving care.
Purpose of the Study:
- To compare pediatric cardiac surgery outcomes between foreign and local surgical teams in Yemen.
- To identify factors influencing complications and mortality.
Main Methods:
- Retrospective cohort study (2004-2019) of 2052 pediatric patients.
- Analysis of demographic data, complications, mortality, and length of stay.
- Utilized the Aristotle Basic Complexity Score (ABC score) for procedure classification.
Main Results:
- Overall complication rate was 36.2%, with a 6.4% mortality rate.
- Surgical complexity and extended hospital stays (>7 days) predicted complications and mortality.
- Local teams managed increased surgical volume with similar mortality but higher complication rates compared to foreign teams.
Conclusions:
- Local surgical teams in Yemen have increased capacity for pediatric cardiac procedures.
- Comparable mortality rates were achieved by local teams versus foreign teams.
- Addressing higher complication rates and prolonged hospital stays under local teams requires targeted training and resource enhancement.
Background:
Congenital heart defects (CHDs) constitute the predominant pediatric congenital anomaly in Yemen, substantially contributing to childhood morbidity and mortality.
Aim:
This study aimed to investigate the outcomes of pediatric cardiac surgery, specifically comparing results between foreign and local surgical teams.
Method:
A retrospective cohort study was conducted using data from January 2004 to December 2019, sourced from a local electronic database and manual registration system. Demographic information, in-hospital complications, mortality, and length of stay were analyzed. The Aristotle Basic Complexity Score (ABC score) was used to categorize surgical procedures.
Results:
The cohort of 2052 patients experienced an overall complication rate of 36.2% and a mortality rate of 6.4%. Extended hospital stays (> 7 days) were associated with a higher complication rate (p < .001). Less complex procedures demonstrated lower complication and mortality rates. Surgical complexity and prolonged hospital stays were identified as predictors of postoperative complications and mortality. While the local team was a predictor of postoperative complications. Notably, mortality did not significantly differ between foreign and local teams (p = .194).
Conclusion:
Local teams successfully increased surgery volume while achieving comparable mortality rates to foreign teams. However, higher complication rates and extended hospital stays persist for cases managed by local teams, underscoring the need for targeted training and resource optimization.
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