Morbidity and mortality in pediatric congenital heart surgery and its association with risk factors in a tertiary hospital in Panama.

Abstract

Introduction:  Mortality in congenital heart surgery varies with surgical complexity, and contributing factors such as younger age, lower weight, comorbidities and postoperative complications have been identified. This study analyzed morbidity and mortality of pediatric congenital heart surgery with cardiopulmonary bypass and clinical- surgical risk factors in a tertiary hospital in Panama.

Materials and methods: Retrospective, analytical cohort study in patients under 15 years of age with congenital heart disease who underwent surgery with cardiopulmonary bypass during the study period (2017-2021). Preoperative, intraoperative and postoperative variables were compared between survivors and deceased patients. A bivariate and multivariate analysis was performed.

Results: 129 patients were included. The most frequent complication was low cardiac output syndrome. In-hospital postoperative mortality was 26.4%. The following were associated with mortality: the neonatal age group, the lower weight, the higher surgical complexity category (RACHS-1), the longer surgical time, low cardiac output syndrome, acute kidney injury, unnplaned reoperation and pulmonary hypertension.

Conclusions: Postoperative complications were similar to those described in the literature and were related to increased mortality. The postoperative complications and the surgical variables are key factors for monitoring and intensive care.