Six months outcomes of young children and adolescents seen with structural heart diseases at the Moi teaching and referral hospital: a prospective cohort study

Abstract

Background: Structural heart diseases impact children globally, hindering progress in reducing pediatric mortality. Understanding outcomes in developing countries is crucial for effective strategies
Objectives: To determine the six-month outcomes and individual factors associated with survival of pediatric cardiac patients presenting at the Moi Teaching and referral hospital, Eldoret.
Study design: A Prospective cohort study
Study setting; The Moi Teaching and Referral Hospital, Eldoret.
Methods: A prospective cohort of newly diagnosed patients was recruited between July 2016 to July 2017 and followed up for a period of six months. The children’s social demographics, clinical presentations, types of cardiac lesions and survival characteristics were obtained.
Results: Out of the 154 participants recruited, 57.1% were female, and the median age was (IQR) 91(18,147), months, 53% had congenital heart disease with patent ductus arteriosus (30.5%), being the commonest lesion. Among patients with, Rheumatic Heart Disease (RHD) the most common lesion seen was mitral valve regurgitation (77.8%). When classified according to the Ross heart failure classification 51.6% were asymptomatic. Using the Kaplan Meier estimates at the end of 182 days of follow-up the survival rate was 83.3%. A log rank test showed no significant difference in survival distribution between RHD and Congenital Heart Disease (CHD)(P=0.558). A higher Ross heart failure classification, cyanosis, and pulmonary hypertension were associated with an increased hazard of death. Most of the deaths occurred in hospital (76.9%), and the main cause of death was heart failure (42.3%)
Conclusion: The survival rate was 83.3%. The hazard of death increased with a higher ross heart failure classification, cyanosis, and increased pulmonary hypertension.