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Published in: Journal of Cardiothoracic Surgery 1/2023

Open Access 01-12-2023 | Ventricular Septal Defect | Research

Epidemiological characteristics and trends in postoperative death in children with congenital heart disease (CHD): a single-center retrospective study from 2005 to 2020

Authors: Guilang Zheng, Jing Wang, Peiling Chen, Zijian Huang, Lei Zhang, Aimei Yang, Jiaxing Wu, Chunlin Chen, Jingwen Zhang, Yueyu Sun, Chengbin Zhou, Haiyun Yuan, Xiaobing Liu, Jianzheng Cen, Shusheng Wen, Yuxiong Guo

Published in: Journal of Cardiothoracic Surgery | Issue 1/2023

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Abstract

Objectives

To analyze the epidemiological characteristics and trends in death after thoracotomy in children with congenital heart disease (CHD).

Methods

The clinical data of children with CHD aged 0–14 years who died after thoracotomy in our hospital from January 1, 2005, to December 31, 2020, were retrospectively collected to analyze the characteristics of and trends in postoperative death.

Results

A total of 502 patients (365 males; 72.7%) died from January 1, 2005, to December 31, 2020, with an average of 31 deaths per year. For these patients, the median age was 2.0 months, the median length of hospital stay was 16.0 days, the median postoperative time to death was 5.0 days, and the median risk adjustment in congenital heart surgery-1 (RACHS-1) score was 3.0. 29.5% underwent emergency surgery, 16.9% had postoperative ECMO support, and 15.9% received postoperative blood purification treatment. In the past 16 years, the deaths of children with CHD under 1 year old accounted for 80.5% of all deaths among children with CHD aged 0–14 years, and deaths (349 cases) under 6 kg accounted for 69.5% of all deaths. Age at death, weight, and disease type were characterized by annual changes.

Conclusions

The postoperative deaths of children with CHD mainly occurred in infants and toddlers who weighed less than 6.0 kg, and TGA and PA were the most lethal CHDs. The proportion of deaths has been increasing across the years among patients who are young, have a low body weight, and have complex cyanotic CHD.
Literature
1.
go back to reference Sadowski SL. Congenital cardiac disease in the newborn infant: past, present, and future. Crit Care Nurs Clin North Am. 2009;21(1):37–48. vi.CrossRefPubMed Sadowski SL. Congenital cardiac disease in the newborn infant: past, present, and future. Crit Care Nurs Clin North Am. 2009;21(1):37–48. vi.CrossRefPubMed
2.
go back to reference Diller GP, Kempny A, Alonso-Gonzalez R, Swan L, Uebing A, Li W, Babu-Narayan S, Wort SJ, Dimopoulos K, Gatzoulis MA. Survival prospects and circumstances of death in contemporary adult congenital heart Disease Patients under Follow-Up at a large Tertiary Centre. Circulation. 2015;132(22):2118–25.CrossRefPubMed Diller GP, Kempny A, Alonso-Gonzalez R, Swan L, Uebing A, Li W, Babu-Narayan S, Wort SJ, Dimopoulos K, Gatzoulis MA. Survival prospects and circumstances of death in contemporary adult congenital heart Disease Patients under Follow-Up at a large Tertiary Centre. Circulation. 2015;132(22):2118–25.CrossRefPubMed
3.
go back to reference Jenkins K. Mortality with congenital heart defects in England and Wales, 1959–2009. Much progress, but more to do. Arch Dis Child. 2012;97(10):859–60.CrossRefPubMed Jenkins K. Mortality with congenital heart defects in England and Wales, 1959–2009. Much progress, but more to do. Arch Dis Child. 2012;97(10):859–60.CrossRefPubMed
4.
go back to reference Kansy A, Tobota Z, Maruszewski P, Maruszewski B. Analysis of 14,843 neonatal congenital heart surgical procedures in the European Association for Card iothoracic surgery congenital database. Ann Thorac Surg. 2010;89(4):1255–9.CrossRefPubMed Kansy A, Tobota Z, Maruszewski P, Maruszewski B. Analysis of 14,843 neonatal congenital heart surgical procedures in the European Association for Card iothoracic surgery congenital database. Ann Thorac Surg. 2010;89(4):1255–9.CrossRefPubMed
5.
go back to reference Gilboa SM, Salemi JL, Nembhard WN, Fixler DE, Correa A. Mortality resulting from congenital heart disease among children and adults in the United States, 1999 to 2006. Circulation. 2010;122(22):2254–63.CrossRefPubMedPubMedCentral Gilboa SM, Salemi JL, Nembhard WN, Fixler DE, Correa A. Mortality resulting from congenital heart disease among children and adults in the United States, 1999 to 2006. Circulation. 2010;122(22):2254–63.CrossRefPubMedPubMedCentral
6.
go back to reference Su ZH, Li SJ, Chen HW, Zhang H. [Comparison of trends in congenital heart disease mortality from 1990 to 2017 between China and North America]. Zhonghua xin xue guan bing za zhi. 2021;49(3):269–75.PubMed Su ZH, Li SJ, Chen HW, Zhang H. [Comparison of trends in congenital heart disease mortality from 1990 to 2017 between China and North America]. Zhonghua xin xue guan bing za zhi. 2021;49(3):269–75.PubMed
7.
go back to reference Liu Z, Liu XR, He CH, Miao L, Kang LN, Li XH, Zhu J, Li Q, Huang Y, Wang YP. [Analysis of mortality and leading causes of death in chinese children under 5-year-old between 2010 and 2016]. Zhonghua Yu Fang Yi Xue Za Zhi. 2019;53(4):411–4.PubMed Liu Z, Liu XR, He CH, Miao L, Kang LN, Li XH, Zhu J, Li Q, Huang Y, Wang YP. [Analysis of mortality and leading causes of death in chinese children under 5-year-old between 2010 and 2016]. Zhonghua Yu Fang Yi Xue Za Zhi. 2019;53(4):411–4.PubMed
8.
go back to reference Zheng G, Wu J, Chen P, Hu Y, Zhang H, Wang J, Zeng H, Li X, Sun Y, Xu G, et al. Characteristics of in-hospital mortality of congenital heart disease (CHD) after surgical treatment i n children from 2005 to 2017: a single-center experience. BMC Pediatr. 2021;21(1):521.CrossRefPubMedPubMedCentral Zheng G, Wu J, Chen P, Hu Y, Zhang H, Wang J, Zeng H, Li X, Sun Y, Xu G, et al. Characteristics of in-hospital mortality of congenital heart disease (CHD) after surgical treatment i n children from 2005 to 2017: a single-center experience. BMC Pediatr. 2021;21(1):521.CrossRefPubMedPubMedCentral
9.
go back to reference Franklin RC, Jacobs JP, Krogmann ON, B¨¦land MJ, Aiello VD, Colan SD, Elliott MJ, William Gaynor J, Kurosawa H, Maruszewski B, et al. Nomenclature for congenital and paediatric cardiac disease: historical perspectives and the Internati onal Pediatric and congenital Cardiac Code. Cardiol Young. 2008;18(Suppl 2):70–80.CrossRefPubMed Franklin RC, Jacobs JP, Krogmann ON, B¨¦land MJ, Aiello VD, Colan SD, Elliott MJ, William Gaynor J, Kurosawa H, Maruszewski B, et al. Nomenclature for congenital and paediatric cardiac disease: historical perspectives and the Internati onal Pediatric and congenital Cardiac Code. Cardiol Young. 2008;18(Suppl 2):70–80.CrossRefPubMed
10.
go back to reference Jenkins KJ, Gauvreau K. Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenita l heart surgery (RACHS-1) method. J Thorac Cardiovasc Surg. 2002;124(1):97–104.CrossRefPubMed Jenkins KJ, Gauvreau K. Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenita l heart surgery (RACHS-1) method. J Thorac Cardiovasc Surg. 2002;124(1):97–104.CrossRefPubMed
11.
go back to reference Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39(12):1890–900.CrossRefPubMed Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39(12):1890–900.CrossRefPubMed
12.
go back to reference van der Bom T, Zomer AC, Zwinderman AH, Meijboom FJ, Bouma BJ, Mulder BJ. The changing epidemiology of congenital heart disease. Nat Rev Cardiol. 2011;8(1):50–60.CrossRefPubMed van der Bom T, Zomer AC, Zwinderman AH, Meijboom FJ, Bouma BJ, Mulder BJ. The changing epidemiology of congenital heart disease. Nat Rev Cardiol. 2011;8(1):50–60.CrossRefPubMed
13.
go back to reference Yuan H, Zhuang J. Current status and the future of congenital cardiac surgery: extrapolating data from Guangdong province. Chin J Clin Thorac Cardiovasc Surg. 2018;11(10):809–15. Yuan H, Zhuang J. Current status and the future of congenital cardiac surgery: extrapolating data from Guangdong province. Chin J Clin Thorac Cardiovasc Surg. 2018;11(10):809–15.
14.
go back to reference Bov¨¦ T, Fran?ois K, De Groote K, Suys B, De Wolf D, Verhaaren H, Matthys D, Moerman A, Poelaert J, Vanhaesebroeck P, et al. Outcome analysis of major cardiac operations in low weight neonates. Ann Thorac Surg. 2004;78(1):181–7.CrossRef Bov¨¦ T, Fran?ois K, De Groote K, Suys B, De Wolf D, Verhaaren H, Matthys D, Moerman A, Poelaert J, Vanhaesebroeck P, et al. Outcome analysis of major cardiac operations in low weight neonates. Ann Thorac Surg. 2004;78(1):181–7.CrossRef
15.
go back to reference Ades A, Johnson BA, Berger S. Management of low birth weight infants with congenital heart disease. Clin Perinatol. 2005;32(4):999–1015. x-xi.CrossRefPubMed Ades A, Johnson BA, Berger S. Management of low birth weight infants with congenital heart disease. Clin Perinatol. 2005;32(4):999–1015. x-xi.CrossRefPubMed
16.
go back to reference Sam¨¢nek M, Benesov¨¢ D, Goetzov¨¢ J, Hrycejov¨¢ I. Distribution of age at death in children with congenital heart disease who died before the age of 15. Br Heart J. 1988;59(5):581–5.CrossRef Sam¨¢nek M, Benesov¨¢ D, Goetzov¨¢ J, Hrycejov¨¢ I. Distribution of age at death in children with congenital heart disease who died before the age of 15. Br Heart J. 1988;59(5):581–5.CrossRef
17.
go back to reference Kempny A, Dimopoulos K, Uebing A, Diller GP, Rosendahl U, Belitsis G, Gatzoulis MA, Wort SJ. Outcome of cardiac surgery in patients with congenital heart disease in England between 1997 and 2015. PLoS ONE. 2017;12(6):e0178963.CrossRefPubMedPubMedCentral Kempny A, Dimopoulos K, Uebing A, Diller GP, Rosendahl U, Belitsis G, Gatzoulis MA, Wort SJ. Outcome of cardiac surgery in patients with congenital heart disease in England between 1997 and 2015. PLoS ONE. 2017;12(6):e0178963.CrossRefPubMedPubMedCentral
18.
go back to reference Rong ZENG, Jian ZHUANG, Ji-mei CHEN, Jian-zheng CEN, Yi-qun DING. Early Outcome of Open Heart surgery for congenital Heart Diseases in Low Birth Weight Infants and premature. Chin J Clin Thorac Cardiovasc Surg. 2012;19(1):227–31. Rong ZENG, Jian ZHUANG, Ji-mei CHEN, Jian-zheng CEN, Yi-qun DING. Early Outcome of Open Heart surgery for congenital Heart Diseases in Low Birth Weight Infants and premature. Chin J Clin Thorac Cardiovasc Surg. 2012;19(1):227–31.
19.
go back to reference WA N G S, hun-min SU, Zhao-kang XU, Zhi-wei LIU, Jin-fen CHAO, Ding-fang. S H I Z hen-y in, Z HU De-min, Wen-xiang DING: the timing of surgical corrections of congenital heart disease in neonates and young infants in Shanghai Children’s Medical Center. Chin J Pediatr Surg. 2006;27(4):177–81. WA N G S, hun-min SU, Zhao-kang XU, Zhi-wei LIU, Jin-fen CHAO, Ding-fang. S H I Z hen-y in, Z HU De-min, Wen-xiang DING: the timing of surgical corrections of congenital heart disease in neonates and young infants in Shanghai Children’s Medical Center. Chin J Pediatr Surg. 2006;27(4):177–81.
20.
go back to reference Wernovsky G, Rubenstein SD, Spray TL. Cardiac surgery in the low-birth weight neonate. New approaches. Clin Perinatol. 2001;28(1):249–64.CrossRefPubMed Wernovsky G, Rubenstein SD, Spray TL. Cardiac surgery in the low-birth weight neonate. New approaches. Clin Perinatol. 2001;28(1):249–64.CrossRefPubMed
Metadata
Title
Epidemiological characteristics and trends in postoperative death in children with congenital heart disease (CHD): a single-center retrospective study from 2005 to 2020
Authors
Guilang Zheng
Jing Wang
Peiling Chen
Zijian Huang
Lei Zhang
Aimei Yang
Jiaxing Wu
Chunlin Chen
Jingwen Zhang
Yueyu Sun
Chengbin Zhou
Haiyun Yuan
Xiaobing Liu
Jianzheng Cen
Shusheng Wen
Yuxiong Guo
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2023
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-023-02224-2

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