Key result
In patients undergoing surgical closure of ventricular septal defect, weight under 10 kg at operation significantly increased the odds of a prolonged hospital stay (OR 4.779).
Why the study?
Factors responsible for complications and outcomes of surgical closure of ventricular septal defect vary across cardiac centers globally, prompting an evaluation of outcomes and predictors of morbidity and mortality at a single center.
Cohort (n=166)
No
Odds Ratio: 4.779 (95% CI 2.147–10.636)
p-value: p=<0.001
Surgical VSD closure can be performed with acceptable mortality and morbidity in a developing country tertiary center, though weight <10 kg and longer cardiopulmonary bypass times are significant predictors of prolonged hospital and ICU stays.
Weight <10 kg associated with prolonged stay after VSD closure; hypothesis-generating for optimal surgical timing in small infants.
Background and Aims: Factors responsible for complications and outcomes of surgical closure of ventricular septal defect differ between different cardiac centers globally. In this study, we tried to evaluate outcomes and predictors of morbidity and mortality of surgical closure of VSD in a single center. Methods: The retrospective cohort study was conducted in Shahid Gangalal National Heart Centre from 14th April 2018 to 13th April 2020. It included consecutive series of patients undergoing ventricular septal defect closure as a primary surgery Results: Out of a total 166 patients, males were 100 (60%). Adverse complications occurred on 36 (21%) with mortality of 6 (3.6%). The age ranged from 4 months to 35 years. The weight <10 kgs at the time of operation had significant post-operative prolong ventilation duration (more than 6 hours) with a p value of 0.012; significant prolong ICU stays (>2 days) with a p value of <0.001; significant prolong hospital stay (> 7 days) with a p value of <0.001. The longer CPB time was associated with significantly prolonged ventilation duration (p value 0.001); significant longer ICU stay (p value 0.02). The age <1 year at the time of operation had significant prolonged ICU stay; significantly prolonged hospital stays (p value of 0.033). Severe pulmonary artery hypertension (PAH) and weight up to 10 kgs at the time of operation demonstrated a trend towards association with mortality. Conclusion: Surgical VSD closure can be done with acceptable level of mortality and morbidity in our context.
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Gautam et al. (2021) conducted a cohort in Ventricular septal defect (n=166). Weight < 10 kg at operation vs. Weight ≥ 10 kg at operation was evaluated on Prolonged hospital stay (> 7 days) (OR 4.779, 95% CI 2.147-10.636, p=<0.001). In patients undergoing surgical closure of ventricular septal defect, weight under 10 kg at operation significantly increased the odds of a prolonged hospital stay (OR 4.779).
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