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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

CLAVERIA, Cristián et al. Surgical mortality and risk stratification in pediatric congenital heart surgery: 10-year experience. Rev Chil Cardiol [online]. 2014, vol.33, n.1, pp.11-19. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602014000100001.

Background: Surgical mortality in congenital heart surgery has been commonly used to assess quality of care, but it doesn't take into account the complexity of the procedure performed. The risk score "Risk Adjustment in Congenital Heart Surgery-1" was developed to address this case mix. Objectives: To determine our institution surgical mortality in congenital heart surgery, assess mortality risk using the RACHS-1 score, evaluate our trend in surgical mortality and to compare our results with published data. Methods: Retrospective study of all congenital heart surgeries performed between January 2000 and July 2010. Heart surgeries were stratified according to the RACHS-1 score. The trend in surgical mortality was assessed across 3 consecutive periods. Our results were compared with published data from the Congenital Heart Surgeons' Society and the Society of Thoracic Surgeons. Results: 1658 congenital heart surgeries were performed with 5,9% surgical mortality . Stratified by RACHS-1 score surgical mortality was: Risk category 1 and 2: 2,1%; Risk category 3: 6,2%; Risk category 4: 24,3% and Risk category 6: 20,7% (RR = 9,87; P<0,001). Mortality decreased during the study period from 8,1% to 4,7% (RR = 1,72; P=0,031). Our surgical mortality was similar to that reported by the Congenital Heart Surgeons' Society (4,7% vs. 3.9%. respectively), but higher than that reported by the Society of Thoracic Surgeons (4,7% vs. 2,9%, respectively; RR = 1,65; P=0,013). Conclusions: Our surgical mortality of congenital heart surgery is 5.9%, it decreases along the study period and is comparable to the results of large international surgical databases. Key Words: congenital heart disease; cardiac surgery; outcomes assessment; mortality; risk adjustment

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