A prospective observational study of paediatric cardiac surgery outcomes in a postoperative intensive care unit in Iran

Objective: To evaluate the incidence of complications, morbidity and mortality, and the associated risk factors with mortality at a Paediatric Cardiology Intensiv Care Unit of a developing country. Methods: The prospective observational study was conducted at Shahid Modarres Hospital, Tehran, Iran, from August 2009 to July 2010. A total of 202 patients were monitored from the time they entered the Paediatric Cardiology Intensive Care Unit till their final discharge. SPSS 16 was used for statistical analysis and p 0.05 was considered statistically significant. Results: Of the total, 107 (53%) were male and 95 (47%) were female. The mean age of the patients was 4.5 ± 4.9 years (range: 2 days to 18 years). Among the patients 59 (29.2%) had complications and 25 (12.37%) of them died. A total of 177 (87.6%) survived and were discharged. Infants (p =0.012), cyanotic congenital heart disease (p = 0.002), longer duration of cardiopulmonary bypass (p=0.027), longer aortic cross-clamp time (p=0.038), longer mechanical ventilation time (p 0.006), and early post-operative period (p = 0.05) were associated factors for mortality. According to regression analysis, cyanotic congenital heart disease, longer intubation time, and early post-operative period were major factors for mortality (p = 0.01, p 0.001, and p = 0.001) respectively. Conclusion: Critically ill cyanotic young infants in the first 24 hours after operation experienced high mortality. Prolonged mechanical ventilation was also associated with high mortality.