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Bateson BP, Deng L, Ange B, Austin E, Dabal R, Broser T, Pennington J, Sivakumar S, Lee C, Truong NLT, Jacobs JP, Cervantes J, Kirklin JK, St Louis J. Hospital Mortality and Adverse Events Following Repair of Congenital Heart Defects in Developing Countries. World J Pediatr Congenit Heart Surg 2023; 14:701-707. [PMID: 37386780 DOI: 10.1177/21501351231176189] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
BACKGROUND Mortality associated with the correction of congenital heart disease has decreased to approximately 2% in developed countries and major adverse events are uncommon. Outcomes in developing countries are less well defined. The World Database for Pediatric and Congenital Heart Surgery was utilized to compare mortality and adverse events in developed and developing countries. METHODS A total of 16,040 primary procedures were identified over a two-year period. Centers that submitted procedures were dichotomized to low/middle income (LMI) and high income (HI) by the Gross National Income per capita categorization. Mortality was defined as any death following the primary procedure to discharge or 90 days inpatient. Multiple logistic regression models were utilized to identify independent predictors of mortality. RESULTS Of the total number of procedures analyzed, 83% (n = 13,294) were from LMI centers. Among all centers, the mean age at operation was 2.2 years, with 36% (n = 5,743) less than six months; 85% (n = 11,307) of procedures were STAT I/II for LMI centers compared with 77% (n = 2127) for HI centers (P < .0001). Overall mortality across the cohort was 2.27%. There was a statistical difference in mortality between HI centers (0.55%) versus LMI centers (2.64%) (P < .0001). After adjustment for other risk factors, the risk of death remained significantly higher in LMI centers (odds ratio: 2.36, 95% confidence interval: 1.707-3.27). CONCLUSION Although surgical expertise has increased across the globe, there remains a disparity with some outcomes associated with the correction of congenital heart disease between developing and developed countries. Further studies are needed to identify specific opportunities for improvement.
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Affiliation(s)
| | - Luqin Deng
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittany Ange
- Department of Surgery, Augusta University, Augusta, GA, USA
| | - Erle Austin
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Louisville, KY, USA
| | - Robert Dabal
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Sivalingam Sivakumar
- Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia
| | - Cheul Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul St.Mary's Hospital, Seoul, Republic of Korea
| | | | - Jeffery P Jacobs
- Department of Surgery, University of Florida, Gainesville, FL, USA
| | - Jorge Cervantes
- Department of Surgery, Instituto Nacional de Cardiologia, Mexico City, Mexico
| | | | - James St Louis
- Department of Surgery, Augusta University, Augusta, GA, USA
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St Louis JD, Deng L, Covington C, Timkovich NA, Crethers D, Collum CS, Pennington JK, Broser T, Dabal RJ, Jacobs JP, O'Brien JE, Austin EH, Tchervenkov CI, Kirklin JK. The World Society for Pediatric and Congenital Heart Surgery: 2021 Update of the World Database for Pediatric and Congenital Heart Surgery. World J Pediatr Congenit Heart Surg 2022; 13:137-145. [PMID: 35238707 DOI: 10.1177/21501351221075604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The World Database for Pediatric and Congenital Heart Surgery (WDPCHS), sponsored by the World Society for Pediatric and Congenital Heart Surgery (WSPCHS), provides complex programmatic outcomes analyses for all members of the WSPCHS. METHODS The Data center, currently at Kirklin Institute for Research in Surgical Outcomes (KIRSO), University of Alabama, Birmingham (USA), provides biannual reports to all active members of the database. This report presents a descriptive analysis of these procedures submitted from January 1, 2017 to December 31, 2020. RESULTS A total of 37,386 procedures were submitted with an overall mortality of 4.3%. The majority of submissions were from Asian countries. The majority of cases submitted from these countries were of Society of Thoracic Surgeons (STS)-European Association for Cardio-Thoracic Surgery (STAT) Mortality Categories I and II. CONCLUSIONS The WSPCHS accomplished one of its missions in 2017 when the WDPCHS began accepting data from pediatric and congenital heart surgery programs across the globe. In doing so, it became one of the first organizations to create a platform for the exchange of knowledge and experience, regardless of the socioeconomic status of the particular program or country.
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Affiliation(s)
| | - Luqin Deng
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | - Craig S Collum
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Taylor Broser
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert J Dabal
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffrey P Jacobs
- Division of Cardiovascular Surgery, Departments of Surgery, University of Florida, Gainesville, FL, USA
| | - James E O'Brien
- Department of Surgery, Children's Mercy Hospital, Kansas City, MO, USA
| | - Erle H Austin
- Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Christo I Tchervenkov
- Division of Pediatric Cardiovascular Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada
| | - James K Kirklin
- KIRSO, University of Alabama at Birmingham, Birmingham, AL, USA
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