[Neonatal cardiac surgery: assessment and comparison of surgical results using the RACHS-1 risk adjustment method]

Autor: Mariano, Ithuralde, María, Ballestrini, Alejandro, Ithuralde, Carlos, Seara, María A, García Nani, Marcelo, Campos, Nelly, Fernández, Pablo, García Delucis, Carlos, Nojek
Rok vydání: 2009
Předmět:
Zdroj: Archivos argentinos de pediatria. 107(3)
ISSN: 1668-3501
Popis: The RACHS-1 method (Risk Adjustment for Congenital Heart Surgery) is widely used to predict mortality and risk adjustment in pediatric cardiovascular surgery and constitutes a valid tool to compare results among different health centers.To analyze if the mortality observed in the neonatal group is related to age and/or the risk stratification according to RACHS-1.From March 2001 to May 2008 we operated on 751 consecutive patients: 160 neonates (0-30 days), 309 infants (31 days-1 year) and 282 olders (1-18 years). Patients in each group were analyzed according to age, RACHS-1, and mortality. We used a logistic regression in which the mortality was the dependent variable and the age and RACHS-1 the independent variables.The total crude mortality was 4.3%, the neonatal 9.2%. We observed a significant statistical difference of RACHS-1 distribution according to age (chi(2)= 219, p0.0001). Logistic analysis showed no statistical difference of mortality (p0.05) in the age groups compared to RACHS-1. Furthermore, RACHS-1 is a most powerful mortality predictor (p0.001) while age is not (p= 0.8). Using our unit one of RACHS-1 as control group, the odds ratio of the different ages were 2.1 (CI 95%: 1.6-2.7) for each RACHS group.The age of surgery was not an independent risk factor as to mortality. The RACHS-1 method appeared as a powerful risk factor predictor of mortality; no differences were found in the age groups when classified by RACHS -1.
Databáze: OpenAIRE