Prospective evaluation of acute neurological events after paediatric cardiac surgery
OBJECTIVES: Children with CHD are at heightened risk of neurodevelopmental problems; however, the contribution of acute neurological events specifically linked to the perioperative period is unclear.
AIMS: This secondary analysis aimed to quantify the incidence of acute neurological events in a UK paediatric cardiac surgery population, identify risk factors, and assess how acute neurological events impacted the early post-operative pathway.
METHODS: Post-operative data were collected prospectively on 3090 consecutive cardiac surgeries between October 2015 and June 2017 in 5 centres. The primary outcome of analysis was acute neurological event, with secondary outcomes of 6-month survival and post-operative length of stay. Patient and procedure-related variables were described, and risk factors were statistically explored with logistic regression.
RESULTS: Incidence of acute neurological events after paediatric cardiac surgery in our population occurred in 66 of 3090 (2.1%) consecutive cardiac operations. 52 events occurred with other morbidities including renal failure (21), re-operation (20), cardiac arrest (20), and extracorporeal life support (18). Independent risk factors for occurrence of acute neurological events were CHD complexity 1.9 (1.1-3.2), p = 0.025, longer operation times 2.7 (1.6-4.8), p < 0.0001, and urgent surgery 3.4 (1.8-6.3), p < 0.0001. Unadjusted comparison found that acute neurological event was linked to prolonged post-operative hospital stay (median 35 versus 9 days) and poorer 6-month survival (OR 13.0, 95% CI 7.2-23.8).
CONCLUSION: Ascertainment of acute neurological events relates to local measurement policies and was rare in our population. The occurrence of acute neurological events remains a suitable post-operative metric to follow for quality assurance purposes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Cardiology in the young - (2024) vom: 14. März, Seite 1-9 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Frost, Olivia [VerfasserIn] |
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| Links: |
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| Themen: |
CHD |
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| Anmerkungen: |
Date Revised 14.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1017/S1047951124000167 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369722841 |
|---|
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| 245 | 1 | 0 | |a Prospective evaluation of acute neurological events after paediatric cardiac surgery |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 14.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a OBJECTIVES: Children with CHD are at heightened risk of neurodevelopmental problems; however, the contribution of acute neurological events specifically linked to the perioperative period is unclear | ||
| 520 | |a AIMS: This secondary analysis aimed to quantify the incidence of acute neurological events in a UK paediatric cardiac surgery population, identify risk factors, and assess how acute neurological events impacted the early post-operative pathway | ||
| 520 | |a METHODS: Post-operative data were collected prospectively on 3090 consecutive cardiac surgeries between October 2015 and June 2017 in 5 centres. The primary outcome of analysis was acute neurological event, with secondary outcomes of 6-month survival and post-operative length of stay. Patient and procedure-related variables were described, and risk factors were statistically explored with logistic regression | ||
| 520 | |a RESULTS: Incidence of acute neurological events after paediatric cardiac surgery in our population occurred in 66 of 3090 (2.1%) consecutive cardiac operations. 52 events occurred with other morbidities including renal failure (21), re-operation (20), cardiac arrest (20), and extracorporeal life support (18). Independent risk factors for occurrence of acute neurological events were CHD complexity 1.9 (1.1-3.2), p = 0.025, longer operation times 2.7 (1.6-4.8), p < 0.0001, and urgent surgery 3.4 (1.8-6.3), p < 0.0001. Unadjusted comparison found that acute neurological event was linked to prolonged post-operative hospital stay (median 35 versus 9 days) and poorer 6-month survival (OR 13.0, 95% CI 7.2-23.8) | ||
| 520 | |a CONCLUSION: Ascertainment of acute neurological events relates to local measurement policies and was rare in our population. The occurrence of acute neurological events remains a suitable post-operative metric to follow for quality assurance purposes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CHD | |
| 650 | 4 | |a Cardiac surgery | |
| 650 | 4 | |a paediatric cardiology | |
| 650 | 4 | |a paediatric neurology | |
| 650 | 4 | |a post-operative outcomes | |
| 700 | 1 | |a Ridout, Deborah |e verfasserin |4 aut | |
| 700 | 1 | |a Rodrigues, Warren |e verfasserin |4 aut | |
| 700 | 1 | |a Wellman, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Cassidy, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Tsang, Victor T |e verfasserin |4 aut | |
| 700 | 1 | |a Dorobantu, Dan |e verfasserin |4 aut | |
| 700 | 1 | |a Stoica, Serban C |e verfasserin |4 aut | |
| 700 | 1 | |a Hoskote, Aparna |e verfasserin |4 aut | |
| 700 | 1 | |a Brown, Katherine L |e verfasserin |4 aut | |
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