Supervivencia a largo plazo de pacientes con complicaciones posoperatorias de la cirugía cardiaca: Experiencia de un instituto pediátrico especializado del Perú, 2001-2019

Luis Eduardo Silva-Delgado; Alfredo Jáuregui-Farfán; Carlos Espiche-Salazar; Piero Larco-Castilla; Rocío Dávalos-Quevedo; Katherine Silva-Delgado; Eduardo Wilfredo Silva-Rivera

doi:10.58597/rpe.v3i4.94

Authors

Luis Eduardo Silva-Delgado Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú https://orcid.org/0000-0002-8263-2540
Alfredo Jáuregui-Farfán Icahn School of Medicine en Mount Sinai, Nueva York, AL, Estados Unidos de América https://orcid.org/0000-0002-1980-0775
Carlos Espiche-Salazar Saint Barnabas Hospital, Nueva York, AL, Estados Unidos de América https://orcid.org/0000-0002-1706-6052
Piero Larco-Castilla Metropolitan Hospital, Nueva York, AL, Estados Unidos de América https://orcid.org/0000-0001-7776-6264
Rocío Dávalos-Quevedo Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú https://orcid.org/0000-0002-3975-8914
Katherine Silva-Delgado Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú https://orcid.org/0009-0002-7335-0274
Eduardo Wilfredo Silva-Rivera Departamento de Cirugía de tórax y cardiovascular, Unidad postoperatoria cardiovascular, Instituto Nacional de Salud del Niño, Lima, Perú https://orcid.org/0000-0002-2705-6288

DOI:

https://doi.org/10.58597/rpe.v3i4.94

Keywords:

Thoracic Surgery, Cardiopulmonary Bypass, Postoperative Complication

Abstract

Objective: To evaluate the impact of complications on short- and long-term survival after cardiac surgery. Materials and methods: Retrospective cohort of patients after their first cardiac surgery at the Instituto Nacional de Salud del Niño from 2001 to 2019. A multivariate and Cox regression analysis identified predictors of early and late complications and mortality. Results: 1709 children were included and the overall rate of major complications was 29.3%; being 20% cardiac and 17.1% extracardiac. Overall mortality was 11.9%, with operative mortality (30 days or before hospital discharge) being 6.4% and 8.9% at one year. A higher number of complications affected operative (p < 0.0001), 90-day (p < 0.0001), 120-day (p < 0.0001) and 1-year (p < 0.0001) mortality. Reoperation (HR = 2.3; 95 % CI: 1.6-3.4), low cardiac output (HR = 8.5; 95 % CI: 6.0-12.0), cardiac arrest (HR = 7.7; 95 % CI: 4.3-13.6), sepsis (HR = 8.1; 95 % CI: 5.8-11.5) and peritoneal dialysis (HR = 3.7; 95 % CI: 2.3-6.2) were associated with higher 1-year mortality. Conclusions: There is a strong association between the type and number of postoperative complications with decreased early and long-term survival. It is justified to identify and control risk factors in early stages.

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