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

Nguyen Tran Viet Tanh1,2, Pham Viet Hoang1,2, Nguyen Cao Hoang Nam1,2, Ho Van Anh Dung1,2, Le Thi Duyen Ngoc1,2, Hoang Sy Quang1,2, Lam Trung Hieu1,2, Nguyen Thi Anh Thoa1,2, Nguyen Van Loc1,2, Trinh Huu Tung1,2
1 Children's Hospital 2
2 Bệnh viện Nhi Đồng 2
DOI: 10.52163/yhc.v67icd10.5851
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Keywords
Congenital heart disease, pediatric cardiac surgery, in-hospital mortality, RACHS-1, logistic regression.
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.

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