Incidence of Cardiac Arrest and In-Hospital Mortality After Pediatric Congenital Heart Surgery in a Middle-Income Country
Issued Date
2025-01-01
Resource Type
ISSN
21501351
eISSN
2150136X
Scopus ID
2-s2.0-105023493669
Pubmed ID
41032652
Journal Title
World Journal for Pediatric and Congenital Heart Surgery
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SCOPUS
Bibliographic Citation
World Journal for Pediatric and Congenital Heart Surgery (2025)
Suggested Citation
Chaikittisilpa N., Tungsawat K., Rattana-Arpa S., Srikongrak S., Aroonpruksakul N., Tocharoenchok T., Kiatchai T. Incidence of Cardiac Arrest and In-Hospital Mortality After Pediatric Congenital Heart Surgery in a Middle-Income Country. World Journal for Pediatric and Congenital Heart Surgery (2025). doi:10.1177/21501351251375444 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113442
Title
Incidence of Cardiac Arrest and In-Hospital Mortality After Pediatric Congenital Heart Surgery in a Middle-Income Country
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Corresponding Author(s)
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Abstract
Objectives: This study aimed to report the incidence of cardiac arrest and in-hospital mortality after pediatric congenital heart surgery in a middle-income country. Methods: This retrospective cohort study was conducted in Thailand. Patients <18 years of age who underwent congenital heart surgery between 2014 and 2019 and experienced cardiac arrest following surgery during the same hospital stay were included. We examined the characteristics of patients who experienced cardiac arrest and its management to determine the mortality-associated factors following cardiac arrest. Results: Overall, 116 cases of cardiac arrest following 1,928 congenital heart surgery operations were included, which resulted in 93/116 (80%) deaths. The incidence of cardiac arrest and in-hospital mortality per 100 patients (95% confidence interval) were 6.0% [116/1,928 (5.0%-7.2%)] and 4.8% [93/1,928 (4.0%-5.9%)], respectively. The incidence of cardiac arrest was higher in neonates (33.6%, 47/140), high-risk STAT 5 surgery (54.8%, 23/43), and emergent/urgent surgery (25.4%, 81/319). Most cardiac arrests occurred within 24 h (66/116, 57%) and in the intensive care unit (90/116, 78%). The most common cause of cardiac arrest was cardiovascular-related (74.1%, 86/116). Multivariable analysis showed the factors associated with mortality (adjusted odds ratio, [95% confidence interval]) included cardiac arrest after 72 h (5.594 [1.073-29.167]), multiple cardiac arrests (10.231 [1.884-55.566]), and every minute increase in cardiopulmonary resuscitation (1.027 [1.005-1.048]). Conclusions: Congenital heart surgery at our middle income cardiac surgical center was associated with relatively high incidence rates of cardiac arrest and in-hospital mortality, and a very high mortality rate following cardiac arrest. The mortality-associated factors after cardiac arrest were cardiac arrest after 72 h, multiple cardiac arrests, and longer duration of cardiopulmonary resuscitation.