Magnitude and Risk Factors for Paediatric Congenital Heart Surgery Complication and its association with Patient Outcomes in the Cardiac Center of Ethiopia

Abstract

BACKGROUND: Congenital heart disease surgery is related to significant postoperative complications which have been associated with poor patient outcomes. However, the prevalence, predictors, and effect of complications on outcomes have only been evaluated in a few numbers of studies. This study aimed to assess the magnitude of postoperative complications after congenital heart surgery, their predictors, and the associations between complications and patient outcomes.

METHODS: A retrospective, single-center cross-sectional study was done at the Cardiac Center of Ethiopia (CCE) on children who had undergone cardiac surgery between 2009 and 2022. All 919 pediatric patients aged below 18 years who had undergone congenital heart surgery were included in the study.

RESULT: Of the 919 patients who underwent surgery in the cardiac center of Ethiopia, Ventricular septal defect( VSD) was the most common diagnosis (41%) and VSD patch closure (39.4%) was the most common surgical procedure. The presence of at least one complication was identified in 39.5% of patients. Of all patients, 11.3% had cardiac, 23.1% had extra-cardiac complications, and 5.3%% had major complications. Higher age at diagnosis, lower weight at admission, cyanotic congenital heart disease, higher Risk adjustment for congenital heart surgery score (RACH-1 score), higher vasoactive inotropic score, Cardiopulmonary bypass use during surgery, higher cardiopulmonary bypass time, higher aortic cross-clamp time, higher duration of surgery, and the higher number of surgeries were associated with complications. The duration of mechanical ventilation, length of intensive care unit stays, and length of hospital stay was significantly prolonged in patients with complications.         

CONCLUSION: Congenital heart disease surgeries pose a high risk of complications, and these complications are associated with poor patient outcomes in Ethiopia. Therefore, predicting complications based on risk factors and early detection and treatment is crucial to improve the patient's outcome.