Epidemiological Assessment of Pediatric Cardiovascular Surgical Pathologies at a Public Hospital in the State of Santa Catarina, Brazil / Avaliação Epidemiológica de Patologias Cirúrgicas Cardiovasculares Pediátricas num Hospital Público do Estado de Santa Catarina, Brasil

Giovana Costa Pellissari, Marina Duda Ronconi, Amanda Tami Kitaura, Cassio Fon Ben Sum, Elisa Henning, Selma Cristina Franco

Abstract


Introduction: to describe the epidemiological profile of patients cared for by the pediatric cardiac surgery service at a referral center in the State of Santa Catarina, Brazil, during five years. Methods: retrospective, longitudinal cohort-type study of cardiovascular surgeries performed in children aged less than 18 years in a Unified Health System-affiliated hospital, from 3rd August 2013 to 2nd August 2018. Patients' demographic, clinical, and healthcare characteristics were assessed. The complexity and severity of the surgeries were assessed using the RACHS-1 method. Negative outcomes were deaths up to thirty days after surgery and complications (mediastinitis, renal failure, and systemic infection). Results: 1,191 procedures were performed, with a predominance of male (53.5%) infants (52.8%) from more near regions of the state (33.6%) and prevalence of RACHS-1 category 3 (36.5%). Most patients had undergone cardiopulmonary bypass (53.7%), mechanical ventilation (94.8%), and only one surgical procedure (56.3%). The most frequent pathology was ventricular septal defect. (15.7%). The median length of hospital stay was eighteen days, six days at intensive care units, and three days of preoperative waiting time. Lethality up to 30 days after surgery was 6%, and complications affected 22.4% of patients. The main factor associated with negative outcomes was represented by the RACHS-1 score with higher categories. Conclusion: This Unified Health System pediatric cardiac surgery service was relevant due to the magnitude of the procedures performed, and the healthcare complexity involved. The set of outcomes presented in this study indicated good healthcare quality in comparison to national standards.


Keywords


Surgery, RACHS-1, Outcomes, Heart Defects, Congenital, Postoperative Complications

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DOI: https://doi.org/10.34117/bjdv.v7i5.30287

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