Risk stratification models for congenital heart surgery in children: Comparative single‐center study

Pérez, Sandra Martínez; Sanchez‐de‐Toledo, Joan; Segura, Susana; Girona‐Alarcón, Mònica; Mele, Maria Cristina; Solé‐Ribalta, Anna; Vazquez, Debora Cañizo; Jordan, Iolanda; Cambra, Francisco José

doi:10.1111/chd.12846

Cited by 17 publications

(13 citation statements)

References 37 publications

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“…Previous studies [16] have reported that a low T3 level was an independent predictor of ICU mortality, which is consistent with our finding. However, for CHD patients, especially children, RACHS-1 scores could predict ICU mortality, length of ICU stay and duration of MV [17][18][19][20]. In our study, compared with survivors, non-survivors had higher RACHS-1 scores.…”

Section: Discussionmentioning

confidence: 55%

Preoperative thyroid hormone levels predict ICU mortality after cardiopulmonary bypass in congenital heart disease patients younger than 3 months old

Zou

Cun

et al. 2021

BMC Pediatr

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Background We aimed to study the effectiveness of preoperative thyroid hormone levels in predicting intensive care unit (ICU) mortality after cardiopulmonary bypass (CPB) in infants with congenital heart disease (CHD). Methods We retrospectively reviewed and analyzed data from 133 patients younger than 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 a Risk Adjustment for 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 than in non-survivors. In the ICU mortality prediction assessment, FT3 was an independent mortality predictor and showed a high AUC (0.856 ± 0.040). Conclusions The preoperative FT3 level was a powerful and independent predictor of ICU mortality after CPB in infants with CHD younger than 3 months old.

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Section: Discussionmentioning

confidence: 55%

Preoperative thyroid hormone levels predict ICU mortality after cardiopulmonary bypass in congenital heart disease patients younger than 3 months old

Zou

Cun

et al. 2021

BMC Pediatr

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“…A 2016 study by Hörer et al [14] suggested that the ABC score had a low predictive value but outperformed the STAT score. In 2019, Bobillo-Perez et al [15] indicated that the predictive performance of the STAT score was better than that of the ABC score. [16] The controversial state of scoring systems in the adult group caused the search for a new scoring system.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of mortality scores in patients with adult congenital heart defects

Recep¹

2022

Cardiovasc Surg Int

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Objectives: Currently, there is no approved risk stratification for adult congenital heart surgery; accordingly, this study aimed to evaluate risk stratification for congenital heart surgery in the pediatric age in terms of its prognostic value in adult patients as well as the effectiveness of the newly developed Adult Congenital Heart Surgery (ACHS) score in this patient group. Patients and methods: A total of 205 patients (115 males, 90 females; mean age: 25.0±11.4 years; range, 18 to 65 years) operated on due to congenital heart disease between January 1, 2011, and August 1, 2019, were studied retrospectively. Aristotle Basic Complexity (ABC) score, Society of Thoracic Surgery European Association for Cardiothoracic Surgery (STAT) score, and ACHS score were evaluated. Receiver operating characteristic (ROC) curves were created to evaluate the ability of scoring systems to predict mortality. Results: The mortality rate was 4.4% (n=9). For mortality, areas under the ROC curve were 0.89, 0.89, and 0.70 for ABC, STAT, and ACHS scores, respectively. The mean ACHS score was 0.42±0.34. The cut-off point of the ACHS score was identified as 0.7 and above. The specificity of the cut-off value of 0.7 regarding the ACHS score was 94.39%. Adult Congenital Heart Surgery scores were found to be statistically high in patients with mortality (p=0.037; p<0.05). Conclusion: Adult Congenital Heart Surgery scores had higher specificity in determining mortality in cases with an ACHS score of 0.7 and above. The ACHS score could also be used to determine the expected mortality rate, similar to the ABC and STAT scores.

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“…Previous studies 16 have reported that low T3 was an independent predictor of ICU mortality, which is consistent with our nding. However, for CHD patients, especially children, RACHS-1 scores could predict ICU mortality, length of ICU stay and duration of MV [17][18][19][20] . In our study, compared with survivors, non-survivors had a higher RACHS-1 score.…”

Section: Discussionmentioning

confidence: 99%

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

Zou

Cun

et al. 2020

Preprint

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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.

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Risk stratification models for congenital heart surgery in children: Comparative single‐center study

Cited by 17 publications

References 37 publications

Preoperative thyroid hormone levels predict ICU mortality after cardiopulmonary bypass in congenital heart disease patients younger than 3 months old

Preoperative thyroid hormone levels predict ICU mortality after cardiopulmonary bypass in congenital heart disease patients younger than 3 months old

Evaluation of mortality scores in patients with adult congenital heart defects

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

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Risk stratification models for congenital heart surgery in children: Comparative single‐center study

Cited by 17 publications

References 37 publications

Preoperative thyroid hormone levels predict ICU mortality after cardiopulmonary bypass in congenital heart disease patients younger than 3 months old

Preoperative thyroid hormone levels predict ICU mortality after cardiopulmonary bypass in congenital heart disease patients younger than 3 months old

Evaluation of mortality scores in patients with adult congenital heart defects

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

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