Risk factors associated with the survival of patients undergoing cardiac surgery with extracorporeal circulation in a Peruvian pediatric hospital

Abstract

Background:The clinical picture of patients with cardiac surgery with extracorporeal circulation (CPB) includes a series of signs and symptoms caused by organ dysfunction associated with cardiac output, which increase the probability of death. Objective: To identify the factors associated with the medium-term survival of patients undergoing cardiac surgery with extracorporeal circulation at the National Institute of Child Health in Lima-Peru. Materials and methods: This observational study analyzed a retrospective cohort of 1028 children who underwent surgery between 2001 and 2010. Survival was estimated using Kaplan-Meier curves; Cox regression was used to analyze the variables considered risk factors for mortality in the medium term. Results: From the preoperative surgical history, emergency surgery (100%), congenital (99.4%) and cyanotic (68.8%) were more prevalent in children under one year of age. In the intraoperative characteristics, the CPB time was 90.5(60-146.5) minutes for children under one year of age and was longer for the other age groups. After surgery, reoperations occurred in 3.2%, reintubation in 10.7%, and the mean ICU and hospital stay was 6 ± 10.4 and 30.7 ± 37 days, respectively. Overall survival showed that patients operated on with CPB had a mortality rate of less than 10%. When survival was demonstrated in age subgroups, it was shown that patients under one year of age had a higher mortality rate, followed by those over 5 years of age. Conclusion: Survival was very high in the medium term. Low cardiac output is a factor associated with mortality after cardiac surgery, which implies monitoring in this type of patient.