Articles T67 Số CDD10 - HN Bệnh viện Nhi Đồng 2 - HN Trường Đại học Nguyễn Tất Thành

OUTCOMES OF CONGENITAL HEART SURGERY AND FACTORS ASSOCIATED WITH IN-HOSPITAL MORTALITY AT CHILDREN'S HOSPITAL 2 DURING 2018–2022

Tanh Nguyen Tran Viet1,2, Hoang Pham Viet1,2, Nam Nguyen Cao Hoang1,2, Dung Ho Van Anh1,2, Ngoc Le Thi Duyen1,2, Quang Hoang Sy1,2, Hieu Lam Trung1,2, Thoa Nguyen Thi Anh1,2, Loc Nguyen Van1,2, Tung Trinh Huu1,2
1 Children's Hospital 2
2 Bệnh viện Nhi Đồng 2
DOI: 10.52163/yhc.v67icd10.5851
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Abstract

Objective: To describe the clinical characteristics, evaluate the outcomes of congenital heart surgery, and identify factors associated with in-hospital mortality at Children's Hospital 2 from 2018 to 2022.

Methods: Single-center retrospective cohort study of 900 patients. Two logistic regression models were constructed: Model 1 included preoperative variables; Model 2 additionally included postoperative complications to explore their association with in-hospital mortality.

Results: Males 53.2%; mean age 483 days. VSD most common (48.4%). In-hospital mortality was 5.7% (51/900). Mortality increased during 2021–2022, and was significantly higher than in the pre-pandemic 2018–2019 period (7.2% vs. 4.9%; p = 0.032). Model 1: RACHS-1 (OR = 2.45), heart failure (OR = 2.12), age < 30 days (OR = 1.92), pulmonary hypertension (OR = 1.88), weight < 3 kg (OR = 1.78), SpO2 < 85% (OR = 1.65); AUC = 0.81. Model 2 added postoperative complications (OR = 2.67); AUC = 0.86.

Conclusion: RACHS-1 complexity and preoperative heart failure were the strongest factors associated with in-hospital mortality. Postoperative complications may lie on the pathway between preoperative severity and in-hospital mortality. However, formal mediation analysis was not performed and further studies are needed to clarify this relationship.

Keywords
Congenital heart disease, pediatric cardiac surgery, in-hospital mortality, RACHS-1, logistic regression.
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