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2015, Number S3

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Rev Med Inst Mex Seguro Soc 2015; 53 (S3)

Prognostic factors associated with postoperative morbidity in children with isolated ventricular septal defect

Castro-Rodríguez CO, Rodríguez-Hernández L, Estrada-Loza MJ, Herrera-Márquez JR, Gómez-Salvador M, Flores-Lujano J, Núñez-Enríquez JC

Language: Spanish
References: 31
Page: 324-335
PDF size: 326.10 Kb.


ABSTRACT

Background: Isolated ventricular septal defect (VSD) is one of the most common congenital heart diseases worldwide. Prognostic factors associated with postoperative morbidity in patients with isolated VSD in the Hospital de Pediatría del Centro Médico Nacional Siglo XXI have not been identified.
Methods: A retrospective cohort study was conducted from January 1, 2009 to December 31, 2013. Descriptive statistics and comparisons between groups were performed using chi-square test, Mann Whitney U test and linear regression. Relative risks (RR) and 95 % confidence intervals (95% CI) were calculated.
Results: A total of 64 patients who underwent isolated VSD closure were included, 12.5 % (n = 8) had a history of pulmonary banding and 22 patients (34.3 %) had Down syndrome. The perimembranous and subaortic lesions occurred in 70 % of cases. Factors associated with an increased morbidity and a prolonged intensive care unit (ICU) stay were: lactate at the end of extracorporeal circulation (ECC) greater than 3 mmol/L (p = 0.02) and Down syndrome (p = 0.02), who had the highest incidence of postoperative complications (p = 0.02).
Conclusions: A statistically significant association was found: the higher the preoperative functional class, the longer the hospital stay, the number of days at ICU and the hours of mechanical ventilation.


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