Factors associated with poor outcomes after congenital heart surgery in low-resource setting in Pakistan: insight from the IQIC Registry – a descriptive analysis

ObjectiveThis study aimed to assess the International Quality Improvement Collaborative single-site data from a developing country to identify trends in outcomes and factors associated with poor outcomes.DesignRetrospective descriptive study.SettingThe National Institute of Cardiovascular Diseases,...

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Published in:	BMJ open 2023-12, Vol.13 (12), p.e078884-e078884
Main Authors:	Furnaz, Shumaila, Shaikh, Abdul Sattar, Qureshi, Rayyan, Fatima, Subhani, Bangash, Sohail Khan, Karim, Musa, Amanullah, Muneer
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Age Cardiovascular disease Cardiovascular Medicine Child Child, Preschool Clinical outcomes Collaboration Congenital diseases congenital heart disease Developing countries echocardiography Female Heart Defects, Congenital - surgery Heart surgery Hospital Mortality Hospitals Humans Infant Infections LDCs Male Mortality paediatric cardiac surgery Pakistan - epidemiology Patients Pediatrics Population Quality improvement Registries Retrospective Studies Risk Factors Sepsis Ventilators
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Summary:	ObjectiveThis study aimed to assess the International Quality Improvement Collaborative single-site data from a developing country to identify trends in outcomes and factors associated with poor outcomes.DesignRetrospective descriptive study.SettingThe National Institute of Cardiovascular Diseases, Karachi, Pakistan.ParticipantsPatients undergoing surgery for congenital heart disease (CHD).Outcome measureKey factors were examined, including preoperative, procedural and demographic data, as well as surgical complications and outcomes. We identified risk factors for mortality, bacterial sepsis and 30-day mortality using multivariable logistic regression.ResultsA total of 3367 CHD surgical cases were evaluated; of these, 59.4% (2001) were male and 82.8% (2787) were between the ages of 1 and 17 years. Only 0.2% (n=6) were infants (≤30 days) and 2.3% (n=77) were adults (≥18 years). The in-hospital mortality rate was 6.7% (n=224), and 4.4% (n=147) and 0.8% (n=27) had bacterial sepsis and surgical site infections, respectively. The 30-day status was known for 90.8% (n=3058) of the patients, of whom 91.6% (n=2800) were alive. On multivariable analysis, the adjusted OR for in-hospital mortality was 0.40 (0.29–0.56) for teenagers compared with infancy/childhood and 1.95 (1.45–2.61) for patients with oxygen saturation
ISSN:	2044-6055 2044-6055