Heart defects treatment in Sergipe: propose of resources' rationalization to improve care

Leite, Débora Cristina Fontes; Mendonça, José Teles de; Cipolotti, Rosana; Melo, Enaldo Viera de

doi:10.5935/1678-9741.20120038

Cited by 4 publications

(8 citation statements)

References 13 publications

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“…The total mortality of the sample was 14.7% with an area under ROC curve for RACHS-1 score of 0.738 (95% CI 0.690 to 0.783). In Sergipe, the RACHS-1 score was used to classify 932 procedures performed, with a predominance of category 1 and 2, with a mortality of 8.3% and area under ROC curve of 0.860 (95% CI 0.818 to 0.902) in 10 years of study follow-up [ 13 ] . Jacobs et al.…”

Section: Discussionmentioning

confidence: 99%

“… Reference Local Mortality Duration of the study (years) No. of patients ROC curve Mortality by RACHS-1 category Mattos et al [ 15 ] , 2006 PE 14.7% 5 818 _ 1 and 2 - 8.76% 3 and 4 - 26.12% 5 and 6 - 100% Nina et al [ 16 ] , 2007 MA 17.2% 3 145 _ 1 - 3.8% 2 - 26% 3 - 60% DATASUS- São Paulo, 2011 [ 17 ] SP 7.1% 1 974 _ 1 - 1.3% 2 - 5.1% 3 - 10.4% 4 - 22.5% 5 - 60% 6 - 61.1% Leite et al [ 13 ] , 2012 PE 8.2% 9 932 0.860 1 - 0.25% 2 - 6.6% 3 - 11.1% 4 - 62% 6 - 100% Cavalcanti et al [ 12 ] , 2015 PE 14.7% 4.5 360 …”

Section: Discussionmentioning

confidence: 99%

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Analysis of surgical mortality for congenital heart defects using RACHS-1 risk score in a Brazilian single center

Cavalcante¹,

Souza²,

Júnior³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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INTRODUCTION:Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease.OBJECTIVE:To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period.METHODS:A retrospective date analysis was performed from January 2003 to December 2014. The survey was divided in two periods of six years long each, to check for any improvement in the results. We evaluated the numbers of procedures performed, complexity of surgery and hospital mortality.RESULTS:Three thousand and two hundred and one surgeries were performed. Of these, 3071 were able to be classified according to the score RACHS-1. Among the patients, 51.7% were male and 47.5% were younger than one year of age. The most common RACHS-1 category was 3 (35.5%). The mortality was 1.8%, 5.5%, 14.9%, 32.5% and 68.6% for category 1, 2, 3, 4 and 6, respectively. There was a significant increase in the number of surgeries (48%) and a significant reduction in the mortality in the last period analysed (13.3% in period I and 10.4% in period II; P=0.014).CONCLUSION:RACHS-1 score was a useful score for mortality risk in our service, although we are aware that other factors have an impact on the total mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of surgical mortality for congenital heart defects using RACHS-1 risk score in a Brazilian single center

Cavalcante¹,

Souza²,

Júnior³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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“…In a literature review, we identified a lack of studies reporting data related to hospital or operative mortality in congenital heart disease in our country over the last 10 years [ 19 - 21 ] .…”

Section: Discussionmentioning

confidence: 99%

“…The latest publication includes results of patients operated over 4 years ago and reports 10 years of surgical treatment of congenital heart disease (including adults) in the state of Sergipe, examining differences in outcomes after the surgery centralization from three hospitals [ 21 ] .…”

Section: Discussionmentioning

confidence: 99%

Stratification of complexity in congenital heart surgery: comparative study of the Risk Adjustment for Congenital Heart Surgery (RACHS-1) method, Aristotle basic score and Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STS-EACTS) mortality score

Cavalcanti¹,

Sá²,

Santos³

et al. 2015

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveTo determine whether stratification of complexity models in congenital heart surgery (RACHS-1, Aristotle basic score and STS-EACTS mortality score) fit to our center and determine the best method of discriminating hospital mortality.MethodsSurgical procedures in congenital heart diseases in patients under 18 years of age were allocated to the categories proposed by the stratification of complexity methods currently available. The outcome hospital mortality was calculated for each category from the three models. Statistical analysis was performed to verify whether the categories presented different mortalities. The discriminatory ability of the models was determined by calculating the area under the ROC curve and a comparison between the curves of the three models was performed.Results360 patients were allocated according to the three methods. There was a statistically significant difference between the mortality categories: RACHS-1 (1) - 1.3%, (2) - 11.4%, (3)-27.3%, (4) - 50 %, (P<0.001); Aristotle basic score (1) - 1.1%, (2) - 12.2%, (3) - 34%, (4) - 64.7%, (P<0.001); and STS-EACTS mortality score (1) - 5.5 %, (2) - 13.6%, (3) - 18.7%, (4) - 35.8%, (P<0.001). The three models had similar accuracy by calculating the area under the ROC curve: RACHS-1- 0.738; STS-EACTS-0.739; Aristotle- 0.766.ConclusionThe three models of stratification of complexity currently available in the literature are useful with different mortalities between the proposed categories with similar discriminatory capacity for hospital mortality.

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“…The twelve articles selected (6,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) Regarding the place of publication of the studies, eight were international, conducted in the United States of America (USA) (23) .…”

Section: Review Studymentioning

confidence: 99%

Tools for managing childcare in the postoperative period of cardiac surgery: an integrative review

et al. 2021

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Objective: To analyze the scientific literature on the application of management tools in the postoperative period of pediatric cardiac surgery. Methods: integrative review including studies published between 2004 and 2018 in the following databases: LILACS, BDENF, coleciona SUS, MEDLINE/PUBMED, CINAHL and SCOPUS, via Portal de Periódicos da Capes, Scientific Electronic Library Online (SciELO) and Academic Google research. Results: Twelve articles that met the inclusion criteria were analyzed. The studies demonstrated that strategies such as extracorporeal membrane oxygenation, renal replacement therapy and the risk scores for Risk Adjustment for Congenital Heart Surgery 1 and Aristotle Basic Score favored the stratification the demand for care and predicted the risk for mortality. Final considerations: The applicability of risk scores and emerging strategies for the management of childcare in the postoperative period of cardiac surgery was described by the evaluation of possibilities of performance and/or efficiency of the treatments developed.

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Heart defects treatment in Sergipe: propose of resources' rationalization to improve care

Cited by 4 publications

References 13 publications

Analysis of surgical mortality for congenital heart defects using RACHS-1 risk score in a Brazilian single center

Analysis of surgical mortality for congenital heart defects using RACHS-1 risk score in a Brazilian single center

Stratification of complexity in congenital heart surgery: comparative study of the Risk Adjustment for Congenital Heart Surgery (RACHS-1) method, Aristotle basic score and Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STS-EACTS) mortality score

Tools for managing childcare in the postoperative period of cardiac surgery: an integrative review

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