Literature DB >> 16092458

Survival after surgery for congenital heart defects: does reduced early mortality predict improved long-term survival?

Leif Eskedal1, Peter Skjalg Hagemo, Anne Eskild, Geir Aamodt, Kerry S Seiler, Erik Thaulow.   

Abstract

AIM: The objectives of this study were 1) to compare early mortality (first 30 d after surgery) and long-term survival between two cohorts of patients operated on for congenital cardiac defects, and 2) to evaluate the impact of possible changes in early mortality on long-term survival.
METHODS: 945 patients with congenital cardiac defects, born in 1990-1999 and operated on in the same period were examined in a retrospective cohort study. The patients were divided into three groups: "univentricular cardiac defects", "severe cardiac defects" and "less severe cardiac defects". The study population was divided into two cohorts: group 1 included patients born and operated on in 1990-1994; group 2 included patients born and operated on in 1995-1999. The survival patterns in the two groups were compared.
RESULTS: For all patients, except those with univentricular cardiac defects, early mortality (30 d after surgery) was reduced. Among patients with severe cardiac defects, early mortality was reduced from 18.6% in group 1 to 2.9% in group 2. Among patients with less severe cardiac defects, early mortality was reduced from 6.2% to 1.9%. The improved outcome was maintained during the following 5 y. Overall relative risk of death during follow-up was reduced to 0.31 (95% CI: 0.15-0.56) for patients with severe cardiac defects, and to 0.53 (95% CI: 0.31-0.93) for patients with less severe cardiac defects born and operated on in 1995-1999.
CONCLUSION: Early mortality has been substantially reduced in congenital heart defect patients, and corresponds with significantly improved long-term survival.

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Year:  2005        PMID: 16092458     DOI: 10.1111/j.1651-2227.2005.tb01915.x

Source DB:  PubMed          Journal:  Acta Paediatr        ISSN: 0803-5253            Impact factor:   2.299


  8 in total

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  8 in total

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