%0 Journal Article
%T Surveillance of Pediatric Cardiac Surgical Outcome Using Risk Stratifications at a Tertiary Care Center in Thailand
%A Chodchanok Vijarnsorn
%A Duangmanee Laohaprasitiporn
%A Kritvikrom Durongpisitkul
%A Prakul Chantong
%A Jarupim Soongswang
%A Paweena Cheungsomprasong
%A Apichart Nana
%A Somchai Sriyoschati
%A Thawon Subtaweesin
%A Punnarerk Thongcharoen
%A Ungkab Prakanrattana
%A Jiraporn Krobprachya
%A Julaporn Pooliam
%J Cardiology Research and Practice
%D 2011
%I Hindawi Publishing Corporation
%R 10.4061/2011/254321
%X Objectives. To determine in-hospital mortality and complications of cardiac surgery in pediatric patients and identify predictors of hospital mortality. Methods. Records of pediatric patients who had undergone cardiac surgery in 2005 were reviewed retrospectively. The risk adjustment for congenital heart surgery (RACHS-1) method, the Aristotle basic complexity score (ABC score), and the Society of Thoracic Surgeons and the European Association for Cardiothoracic Surgery Mortality score (STS-EACTS score) were used as measures. Potential predictors were analyzed by risk analysis. Results. 230 pediatric patients had undergone congenital cardiac surgery. Overall, the mortality discharge was 6.1%. From the ROC curve of the RACHS-1, the ABC level, and the STS-EACTS categories, the validities were determined to be 0.78, 0.74, and 0.67, respectively. Mortality risks were found at the high complexity levels of the three tools, bypass time >85£żmin, and cross clamp time >60£żmin. Common morbidities were postoperative pyrexia, bleeding, and pleural effusion. Conclusions. Overall mortality and morbidities were 6.1%. The RACHS-1 method, ABC score, and STS-EACTS score were helpful for risk stratification. 1. Introduction During the past two decades, dramatic improvements have been seen in both diagnostic tools and treatments for heart diseases in pediatric patients. Advances in neonatal surgery, interventional cardiac catheterization, cardiac anesthesia and intensive care, cardiopulmonary bypass systems, and mechanical assisted device have been key achievements in outcomes, especially in the critical patients. The in-hospital mortality rates for pediatric cardiac surgery decreased significantly from 8.7¨C22% to 4.6¨C6% in the past two decades [1¨C5]. Recently, a report on indigenous Australian pediatric patients who had undergone congenital cardiac surgery showed overall complication rates of 20¨C32% and a mortality rate of 1.82%. The major postoperative complications were conduction disturbance (17%), valve dysfunction (6%), and tamponade (3%) [1]. In addition, a mortality outcome of up to 0.62% occurred within 365 days after hospital discharge. Chang et al. [6] indicated that the important risk factors of posthospital discharge death were young age and type of surgery. Silka et al. [7] reported that the majority of these patients had diagnoses of aortic stenosis, coarctation of aorta, transposition of great arteries, and tetralogy of Fallot. The major causes of death were cardiac arrhythmia, aneurysmal rupture, and heart failure. To measure the performance of surgical
%U http://www.hindawi.com/journals/crp/2011/254321/