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

Abstract

Backgroup: To study the effectiveness of thyroid hormones in predicting intensive care unit (ICU) mortality after cardiopulmonary bypass (CPB) in infants with congenital heart disease (CHD). Methods: We retrospective observational analyzed data from 133 patients under 3 months old who underwent cardiac surgery with CPB from June 2017 to November 2019. ICU mortality prediction was assessed by multivariate binary logistic regression analysis and area under the curve (AUC) analysis. Results: Non-survivors were younger (17.46±17.10 days vs. 38.63±26.87 days, P=0.006), with a higher proportion of neonates (9/13 vs. 41/120, P=0.017) and a higher proportion of individuals with Risk Adjustment in Congenital Heart Surgery-1 (RACHS-1) score ≥4 (8/13 vs. 31/120, P=0.020). No significant difference was found in CPB and aortic cross-clamping (ACC) time. The levels of free triiodothyronine (FT3) (3.91±0.99 pmol/L vs. 5.11±1.55 pmol/L, P=0.007) and total triiodothyronine (TT3) (1.55±0.35 nmol/L vs. 1.90±0.57 nmol/L, P=0.032) were higher in survivors compared with non-survivors. In the ICU mortality prediction assessment, only FT3 was an independent mortality predictor and showed a good AUC (0.856 ± 0.040). Conclusion: FT3 was a powerful and the only independent predictor of ICU mortality in CHD infants under 3 months old after CPB.