Factors associated with survival in pediatric patients undergoing cardiac surgery with extracorporeal circulation in Peru, from 2001 to 2020

Abstract

Background: Certain factors have a strong association with survival after pediatric cardiac surgery and are used in the clinical area. 

Objectives: Evaluate the factors associated with survival in pediatric patients undergoing cardiac surgery with extracorporeal circulation. 

Methods: A retrospective cohort study of 1794 pediatric patients undergoing their first cardiac surgery on extracorporeal circulation at a pediatric cardiac surgery center between January 2001 and January 2020 was initiated. All patients were followed from cardiac surgery until death or March 31, 2020. Survival analysis and multivariate Cox regression for risk adjustment were extracted. This study was approved by the Institutional Ethics Committee. 

Results: Survival at one year was 91%, at 5 years 88%, at 10 years 87%, and at 15 years 87%. Cox regression analysis showed that younger age, higher RACHS-1 score, open chest, cardiac arrest, and peritoneal dialysis were independently associated with lower survival (p < 0.001). 

Conclusions: The survival of children undergoing cardiac surgery in our center is very satisfactory. Complications, especially cardiac arrest, and renal failure with peritoneal dialysis, arise in survival after pediatric cardiac surgery. It is necessary to direct strategies to improve processes and prevent postoperative complications.