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Published on: February 8, 2022
Exploring the influence of risk factors on outcomes following surgical closure of ventricular septal defects
Gokcen Ozcifci1, Umut Altug2, Fatih Durak3
1Izmir City Hospital, Department of Paediatric Intensive Care Unit, Izmir, Turkey.
Insights
Younger age, lower weight, and genetic syndromes are key risk factors for longer intensive care and hospital stays after ventricular septal defect surgery. These factors require careful consideration during postoperative care for improved patient outcomes.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease Research
- Intensive Care Medicine
Background:
- Surgical closure of ventricular septal defects (VSDs) is a primary intervention in pediatric cardiac surgery.
- Identifying factors affecting recovery is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To determine risk factors influencing intensive care unit (ICU) stay duration and complications after VSD surgical correction.
- To analyze the impact of patient demographics and specific conditions on postoperative recovery metrics.
Main Methods:
- Retrospective analysis of preoperative, perioperative, and postoperative data from 108 patients undergoing VSD closure.
- Data sources included echocardiography, perfusion reports, and clinical notes.
- Outcome variables: in-hospital mortality, mechanical ventilation duration, PICU stay, and overall hospital stay.
Main Results:
- Younger age and lower body weight were significant risk factors for prolonged PICU stay, hospital stay, and mechanical ventilation.
- Patients with genetic syndromes experienced significantly longer mechanical ventilation times, PICU stays, and hospital stays.
- Complication rates were not significantly impacted by genetic syndromes.
Conclusions:
- Genetic syndromes significantly prolong hospital and PICU stays, and mechanical ventilation duration, though not complication rates.
- Younger age and lower body weight are identified as critical risk factors for extended hospitalization and mechanical ventilation.
- These findings emphasize the need to consider age, weight, and genetic status in postoperative management strategies for VSD patients.
Introduction:
Surgical closure of ventricular septal defects remains the predominant paediatric cardiac surgical intervention. This study aims to identify risk factors influencing the duration of intensive care stay and complications following surgical correction for ventricular septal defects.
Methods:
Preoperative, perioperative, and postoperative data were comprehensively assessed from echocardiography reports, perfusion reports, and clinical, inpatient, and operative notes for all patients. Outcome variables included in-hospital mortality, mechanical ventilation duration (hours), paediatric intensive care unit stay (days), and overall hospital stay (days). The study presents findings from a single paediatric cardiac centre experience spanning from October 2015 to October 2018.
Results:
Among the 108 patients who underwent surgical ventricular septal defect closure, younger age (p < 0.001 for PICU stay, p = 0.001 for hospital stay, and p = 0.036 for mechanical ventilation time) and lower weight (p < 0.001, p = 0.009, and p = 0.006, respectively) were identified as risk factors for prolonged paediatric intensive care unit (PICU) stay, extended hospital stay, and increased mechanical ventilation time. Additionally, patients with genetic syndromes showed significantly longer mechanical ventilation times (p < 0.001), PICU stays (p < 0.001), and hospital stays (p = 0.002).
Conclusion:
While genetic syndromes did not impact complication rates, they significantly influenced the durations of hospital and paediatric intensive care unit stays, as well as mechanical ventilation. Younger age and lower body weight emerged as risk factors for prolonged hospitalisation, extended paediatric intensive care unit stays, and prolonged mechanical ventilation. Consequently, these factors warrant consideration in the postoperative follow-up of patients with ventricular septal defects.
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