AI Article Synopsis
- Tetralogy of Fallot (TOF) is a congenital heart defect leading to low oxygen levels, which may cause anemia and impact recovery after surgery for children.
- This study analyzed data from 596 children who underwent corrective surgery for TOF to determine if preoperative hemoglobin (Hb) and blood oxygen saturation (SpO2) could predict negative outcomes post-surgery.
- Findings showed that a combination of low Hb and SpO2 levels increased the risk of serious complications, longer ICU stays, and higher medical costs, suggesting that monitoring these levels could help clinicians assess surgical risks more effectively.
Article Abstract
Background: Tetralogy of Fallot (TOF) is a common cyanotic congenital heart malformation that carries a high risk of right-to-left shunting. Anemia is characterized by decreased hemoglobin (Hb) levels that can affect tissue oxygen delivery and impact postoperative recovery in patients. Chronic hypoxia caused by right-to-left shunting of TOF could lead to compensatory increases in Hb to maintain systemic oxygen balance. This study aims to investigate whether preoperative Hb and blood oxygen saturation (SpO2) can predict adverse outcomes in children undergoing corrective surgery for TOF.
Methods: This retrospective study included patients under 18 years of age who underwent corrective surgery for TOF at Fuwai Hospital between January 2016 and December 2018. Adverse outcomes, including in-hospital death, extracorporeal membrane oxygenation implantation, ICU stay > 30 days, and severe complications, were considered as the primary outcome. Univariable and multivariable logistic analyses were performed to identify independent risk factors for adverse outcomes. Propensity score-matched (PSM) analysis was also conducted to minimize the confounding factors.
Results: A total of 596 children were included in the study, of which 64 (10.7%) experienced adverse outcomes. Hb*SpO2 < aaHb was identified as an independent risk factor for adverse outcomes (OR = 2.241, 95% CI = 1.276-3.934, P = 0.005) after univariable and multivariable logistic analyses. PSM analysis further confirmed the association between Hb*SpO2 < aaHb and adverse outcomes. Patients with Hb*SpO2 < aaHb had a significantly higher incidence of postoperative adverse outcomes, longer time of mechanical ventilation, and hospital stay, as well as higher in-hospital costs.
Conclusions: Hb*SpO2 < aaHb is significantly associated with adverse outcomes in children undergoing corrective surgery for TOF. Clinicians can use this parameter to early identify high-risk children and optimize their postoperative management.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580598 | PMC |
| http://dx.doi.org/10.1186/s12871-023-02290-y | DOI Listing |
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