Exploring the influence of risk factors on outcomes following surgical closure of ventricular septal defects

Gokcen Ozcifci, Umut Altug, Fatih Durak, Ayse Berna Anil, Pinar Kulluoglu, Onur Isik, Muhammet Akyuz, Tulay Demircan, Nazmi Narin

Abstract

Introduction: Surgical closure of ventricular septal defects remains the predominant paediatric cardiac surgical intervention. This study aims to identify risk factors influencing the duration of intensive care stay and complications following surgical correction for ventricular septal defects.
Methods: Preoperative, perioperative, and postoperative data were comprehensively assessed from echocardiography reports, perfusion reports, and clinical, inpatient, and operative notes for all patients. Outcome variables included in-hospital mortality, mechanical ventilation duration (hours), paediatric intensive care unit stay (days), and overall hospital stay (days). The study presents findings from a single paediatric cardiac centre experience spanning from October 2015 to October 2018.
Results: Among the 108 patients who underwent surgical ventricular septal defect closure, younger age (p < 0.001 for PICU stay, p = 0.001 for hospital stay, and p = 0.036 for mechanical ventilation time) and lower weight (p < 0.001, p = 0.009, and p = 0.006, respectively) were identified as risk factors for prolonged paediatric intensive care unit (PICU) stay, extended hospital stay, and increased mechanical ventilation time. Additionally, patients with genetic syndromes showed significantly longer mechanical ventilation times (p < 0.001), PICU stays (p<0.001), and hospital stays (p = 0.002).
Conclusion: While genetic syndromes did not impact complication rates, they significantly influenced the durations of hospital and paediatric intensive care unit stays, as well as mechanical ventilation. Younger age and lower body weight emerged as risk factors for prolonged hospitalisation, extended paediatric intensive care unit stays, and prolonged mechanical ventilation. Consequently, these factors warrant consideration in the postoperative follow-up of patients with ventricular septal defects.