Analysis of surgical mortality for congenital heart defects using RACHS-1 risk score in a Brazilian single center

Abstract

INTRODUCTION:Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease.OBJECTIVE:To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period.METHODS:A retrospective date analysis was performed from January 2003 to December 2014. The survey was divided in two periods of six years long each, to check for any improvement in the results. We evaluated the numbers of procedures performed, complexity of surgery and hospital mortality.RESULTS:Three thousand and two hundred and one surgeries were performed. Of these, 3071 were able to be classified according to the score RACHS-1. Among the patients, 51.7% were male and 47.5% were younger than one year of age. The most common RACHS-1 category was 3 (35.5%). The mortality was 1.8%, 5.5%, 14.9%, 32.5% and 68.6% for category 1, 2, 3, 4 and 6, respectively. There was a significant increase in the number of surgeries (48%) and a significant reduction in the mortality in the last period analysed (13.3% in period I and 10.4% in period II; P=0.014).CONCLUSION:RACHS-1 score was a useful score for mortality risk in our service, although we are aware that other factors have an impact on the total mortality.

Risk factors for low cardiac output syndrome in children with congenital heart disease undergoing cardiac surgery: a retrospective cohort study

“…The body mass index (BMI), as categorical data percentiles varied according to age groups, which were age-adjusted according to the pediatric BMI reference data for China [14]. Moreover, the Risk Adjustment in Congenital Heart Surgery-1 (RACHS-1) score was defined as ordinal data; an increase in the RACHS-1 score can indicate the risk of LCOS [15]. Nutrition status has been recognized as an important risk factor of postoperative complications in CHD surgery.…”

Recent Surgical Outcomes of Congenital Heart Disease according to Korea Heart Foundation Data

“…These outcomes are comparable to those of other series. [8][9][10] Because these data were based on KHF data from 64 hospitals with semi-mandatory data reporting, we could not evaluate the exact cause of death. Thus, we focused on hospital mortality rates of CHD surgery.…”

Nutritional outcomes in infants with food allergy after cardiac surgery

“…A structure questionnaire was conducted to collect data on the clinical outcomes of study participants. The demographic and laboratory examination data were collected before surgery including gender, age, type of cardiac defect, risk adjustment for congenital heart surgery1 (RACHS‐1) score, the left ventricular ejection fraction (LVEF) from Echo report, serum biochemical indexes including albumin and prealbumin, and eosinophils and hemoglobin in blood routine index. The clinical data were also recorded after surgery, including duration of CPB and aortic cross‐clamp, time of ventilation, duration of hospital stay, nosocomial infection, and plasma aminoterminal brain natriuretic peptide (NT‐BNP) …”