Uncorrected cardiac malformation is the major risk factor for death in patients with dextrocardia

Abstract

Background/Objectives: Dextrocardia is rare in the general population. We aimed to analyze the clinical characteristics and risk factors for survival rate of dextrocardia patients during 2013 to 2018 in our hospital, through a specialized Hospital Information System. Methods: A retrospective study of patients with dextrocardia was performed through Hospital Information System. International Classification of Diseases 10 was searched to identify eligible cases from January 2013 to December 2018 in our hospital. Medical records were reviewed to acquire the basic information of dextrocardia patients. Results: Among 9304 patients diagnosed with congenital heart disease in past six years, 48 (0.51%) had dextrocardia. Among 48 dextrocardia patients, 28 (58.33%) had situs inversus viscerum, 20 (41.67%) had cardiac malformation, nine (18.75%) had other malformations and 16 (33.33%) had no malformation. Compared with patients with uncorrected cardiac malformation, patients without cardiac malformation were older (43.5000 vs 0.4583 years, P＜0.001). The dextrocardia patients'age of onset correlated significantly with cardiac malformation. Multivariable logistic model showed the significant risk factor for survival rate was uncorrected cardiac malformation (odds ratio, 22.2391; P＜0.001). However, situs inversus (odds ratio, 1.9750; P= 0.4399) or pneumonia (odds ratio, 4.2610; P= 0.0849) itself was not a significant risk factor for survival rate. Kaplan Meier plot shown that dextrocardia patients with uncorrected cardiac malformation had lower survival rate than those without cardiac malformation (P＜0.0001), and there is no significant difference between healthy cohort and patients with pure dextrocardia with or without situs inversus (P=0.25). Conclusions: Dextrocardia remains a rare finding in population, even in the group of patients with known congenital heart disease. Dextrocardia was associated with various malformations besides cardiac malformation. Uncorrected cardiac malformation, which should be paid high attention in the developing countries, is the main risk factor for death in patients with dextrocardia, and pure dextrocardia with or without situs inversus has no effect on survival rate of dextrocardia patients.