RACHS-1 score as predictive factor for postoperative ventilation time in children with congenital heart disease

Abstract

<jats:title>Abstract</jats:title><jats:sec id="S1047951120000025_as1" sec-type="other"><jats:title>Background:</jats:title><jats:p>Congenital heart disease is the most frequent malformation in newborns. The postoperative mortality of these patients can be assessed with the Risk Adjustment in Congenital Heart Surgery-1 (RACHS-1) score. This study evaluates whether the RACHS-1 score can also be used as a predictor for the length of postoperative ventilation and what is the influence of age.</jats:p></jats:sec><jats:sec id="S1047951120000025_as2" sec-type="other"><jats:title>Material and Methods:</jats:title><jats:p>In a retrospective study over the period from 2007 to 2013, all patient records were evaluated: 598 children with congenital heart disease and cardiac surgery were identified and 39 patients have been excluded because of additional comorbidities. For evaluation of mortality, 559 patients could be analysed, after exclusion of 39 deceased patients, 520 cases remained for analysis of postoperative ventilation.</jats:p></jats:sec><jats:sec id="S1047951120000025_as3" sec-type="other"><jats:title>Results:</jats:title><jats:p>Overall mortality was 7% with a dependency on RACHS-1 categories. The median length of postoperative ventilation rose according to the RACHS-1 categories: RACHS-1 category 1: 9 hours (interquartile range (IQR) 7–13 hours), category 2: 30 hours (IQR 12–85 hours), category 4: 58 hours (IQR 13–135 hours), category 4: 71 hours (IQR 29–165 hours), and category 6: 189 hours (IQR 127–277 hours). Some of the RACHS-1 subgroups differed significantly from the categories, especially the repair of tetralogy of Fallot with a longer ventilation time and strong variability. Younger age was an independent factor for longer postoperative ventilation.</jats:p></jats:sec><jats:sec id="S1047951120000025_as4" sec-type="other"><jats:title>Conclusion:</jats:title><jats:p>RACHS-1 is a good predictor for the length of postoperative ventilation after cardiac surgery with the exception of some subgroups. Younger age is another independent factor for longer postoperative ventilation. These data provide better insight into ventilation times and allow better planning of operations in terms of available intensive care beds.</jats:p></jats:sec>

Preoperative thyroid hormone levels predict ICU mortality after cardiopulmonary bypass in congenital heart disease patients younger than 3 months old

“…Previous studies [16] have reported that a low T3 level was an independent predictor of ICU mortality, which is consistent with our finding. However, for CHD patients, especially children, RACHS-1 scores could predict ICU mortality, length of ICU stay and duration of MV [17][18][19][20]. In our study, compared with survivors, non-survivors had higher RACHS-1 scores.…”

Human metapneumovirus infection in the cardiac paediatric ICU before and during COVID-19 pandemic: a retrospective cohort analysis

“…The need for mechanical ventilation appears to be longer and mortality higher in human metapneumovirus-infected patients than in patients without human metapneumovirus infection, as shown by recent literature looking at the Risk Adjustment in Congenital Heart Surgery score: Risk Adjustment in Congenital Heart Surgery score category 3, in this analysis, needed ventilation for a median of 10 days (range 0-43 days). Meanwhile in current literature, it is 58 hours (range 13-135 hours) 15 . The mortality in category 3 was 25% in this analysis, whereas 9.5% has been previously reported.…”

Thyroid Hormones Predict ICU&nbsp;Mortality After Cardiopulmonary Bypass in Congenital Heart Disease Patients Under 3 Months Old

“…Previous studies 16 have reported that low T3 was an independent predictor of ICU mortality, which is consistent with our nding. However, for CHD patients, especially children, RACHS-1 scores could predict ICU mortality, length of ICU stay and duration of MV [17][18][19][20] . In our study, compared with survivors, non-survivors had a higher RACHS-1 score.…”