Key result
Weight ≤2.5 kg at the time of complex neonatal cardiovascular surgery did not significantly affect 30-day discharge mortality compared to weight >2.5 kg (7.1% vs 5.1%, p=0.83).
Why the study?
The authors sought to review single-center surgical mortality rates for patients undergoing STAT category 4 or 5 neonatal cardiovascular surgery.
Does weight ≤2.5 kg compared to >2.5 kg affect 30-day discharge mortality in neonates undergoing complex STAT 4 or 5 category cardiovascular surgery?
Cohort (n=239)
No
Does weight ≤2.5 kg compared to >2.5 kg affect 30-day discharge mortality in neonates undergoing complex STAT 4 or 5 category cardiovascular surgery?
Weight ≤2.5 kg at the time of surgery, presence of syndromes, and associated noncardiac malformations did not significantly increase 30-day discharge mortality in neonates undergoing complex STAT 4 or 5 cardiovascular surgery.
Highlights substantial low-birth-weight proportion in high-risk neonatal surgery; leaves open mortality impact and optimal thresholds.
OBJECTIVE: We reviewed our center's surgical mortality rates for those who underwent a Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) category 4 or 5 neonatal cardiovascular surgery. METHODS: We identified all patients who underwent a STAT category 4 or 5 neonatal index cardiovascular surgical procedure between July 2015 and July 2021. RESULTS: We identified 239 patients. We divided them into two groups: (1) 42 (17.6%) ≤2.5 kg, and (2) 197 (82.4%) were >2.5 kg at the time of neonatal surgery. Of those ≤2.5 kg, 18/42 (42.9%) had syndromes or associated noncardiac malformations versus 34/197 (17.3%) of those >2.5 kg, p = .0093. Thirty-day discharge mortality for those ≤2.5 kg was 3/42 (7.1%) versus l0/197 (5.1%) for those >2.5 kg, p = .83. CONCLUSIONS: Weight at the time of surgery, presence of syndromes, and associated noncardiac malformations did not affect mortality in those undergoing complex neonatal STAT 4 or 5 category cardiovascular surgery.
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Evans et al. (2022) conducted a cohort in STAT category 4 or 5 neonatal cardiovascular surgery (n=239). Weight ≤2.5 kg vs. Weight >2.5 kg was evaluated on 30-day discharge mortality (p=0.83). Weight ≤2.5 kg at the time of complex neonatal cardiovascular surgery did not significantly affect 30-day discharge mortality compared to weight >2.5 kg (7.1% vs 5.1%, p=0.83).
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