Risk stratification for adult congenital heart surgery

Abstract

The discriminatory power of the pediatric risk scores was suboptimal, but increased when adding age as a score component. The best performance was achieved by the combination of age and the Comprehensive Aristotle Score, for both 30-day and 1-year mortality.

Validation of the grown-ups with congenital heart disease score

“…As suggested by van Gameren et al , age was included in the GUCH score 4. However, there was no significant correlation between the age at the time of surgery and mortality in the present population.…”

Knowledge and Attitudes of Anesthesia Providers about Noncardiac Surgery in Adults with Congenital Heart Disease

“…Total knowledge scores differed significantly by fellowship background (P = .004), frequency of providing care for cardiopulmonary bypass cases (P < .001), and frequency of providing care for patients less that 2 years of age (P < .001), but not by gender (P = .44), frequency of providing care for obstetric cases (P = .22), or years removed from residency (P = .50). Compared with median [IQR] knowledge scores among respondents without fellowship training (7 [4-12]), knowledge scores were higher among respondents with cardiac (11 [7][8][9][10][11][12][13][14][15], P < .001) and pediatric (12 [6][7][8][9][10][11][12][13][14][15], P = .001) but not critical care (8 [7-10], P = .50) or other (obstetric, regional, or pain management) fellowship training (6.5 [3][4][5][6][7][8][9], P = .57).…”

“…It seems likely that future perioperative outcome studies will improve the evidence base for risk‐stratifying ACHD patients beyond the use of lesion complexity. Existing risk scores for pediatric congenital cardiac operations, e.g., Aristotle; Risk Adjustment in Congenital Heart Surgery 1 and Society of Thoracic Surgeons, have been found to be somewhat predictive when applied to adult congenital cardiac operations . However, risk factors for children with CHD who undergo noncardiac surgery are poorly defined; they are even less well defined for noncardiac surgery in ACHD patients.…”

Avaliação do tratamento cirúrgico da cardiopatia congênita em pacientes com idade superior a 16 anos

“…In this analysis, we used the score of complexity described for congenital heart diseases in general, the Aristotle Basic Score (ABC). The ABC seems to have a suboptimal predictive power in adults 22 . However, as one does not have any specific score validated for this group of patients, the ABC is a possible way to stratify the complexity of patients operated.…”