Objective:
Low body weight has been confirmed as risk factor for early death after neonatal congenital heart surgery. We have studied the data on 12271 neonatal CHS procedures of the EACTS Congenital Database, 1999 – 2008 after excluding PDA procedures.
Methods:
Patients were divided into two groups with body weight 2,5 kg as discriminator and into two surgical eras until and after 2004. 1885 procedures were performed in neonates below 2,5 kg b.w.. 6385 procedures were performed before 2005 and 5886 since. Age, body weight below 2,5 kg, technical difficulty, Aristotle Basic Score, CPB time, AoX time, univentricular physiology and DHCA were studied as potential risk factors for hospital mortality and for onset of complications.
Results:
Hospital mortality was 11,6%, 16,15% below 2,5 kg and 9,14% above(p<0,001). Mortality decreased between two surgical eras from 13,16% to 9,96% (p<0,0001), but only in neonates with body weight above 2,5 kg (12,5% v. 9%, p<0,0001). Multivariate analysis showed that in recent era technical difficulty, ABS, AoX time and DHCA were neutralized as risk factors for hospital mortality. Body weight below 2,5 kg, CPB time and univentricular physiology remain significant determinants of early death. Body weight below 2,5 kg was neutralized as a risk factor for onset of complications after 2004. Recently technical difficulty, ABS, CPB time, univentricular physiology and DHCA remain significant predictors of onset of complications.
Conclusion:
Body weight below 2,5 kg, univentricular physiology and CPB time continue to be risk factors for hospital death in neonatal cardiac surgery.