Association between preoperative anemia and postoperative infection and death in children with acyanotic congenital heart disease undergoing elective cardiac surgery: A retrospective cohort study
- VernacularTitle:术前贫血与非紫绀先天性心脏病患儿择期术后感染和死亡关系的回顾性队列研究
- Author:
Dan ZHOU
1
;
Mei FENG
1
;
Li LI
1
;
Jinping SONG
2
;
Menglin TANG
1
Author Information
1. West China School of Nursing, Sichuan University/Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
2. West China School of Nursing, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Congenital heart disease;
children;
elective surgery;
anemia;
infection;
death
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(10):1354-1361
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the relationship between preoperative anemia and postoperative infection and death in children with acyanotic congenital heart disease (CHD) after elective cardiac surgery. Methods Medical records and follow-up data of 3 859 children with acyanotic CHD who underwent elective cardiac surgery in our hospital from 2011 to 2018 were retrospectively collected, including 2 081 males and 1 778 females with a median age of 32.2 (13.7, 61.5) months. The relationship between preoperative anemia and postoperative infection and death within 90 days was analyzed by univariate and multivariate regression analyses. Results Preoperative anemia was found in 325 (8.4%) patients. There were 716 (18.6%) patients of postoperative infection, including 281 (7.3%) patients of confirmed infection and 435 (11.3%) patients of suspected infection. Forty-six (1.2%) patients died within 90 days after the operation. Univariate analysis showed that age, infection history within 3 months before admission, degree of pulmonary hypertension, the risk adjustment in congenital heart surgery-1 (RACHS-1) score, cardiopulmonary bypass (CPB), disease diagnosis, chromosome abnormality, preoperative left ventricular ejection fraction (LVEF)<55% and preoperative anemia were associated with postoperative infection. Age, degree of pulmonary hypertension, RACHS-1 score, CPB, disease diagnosis and preoperative LVEF<55% were associated with postoperative death within 90 days. Logistic regression analysis showed that preoperative anemia was significantly associated with confirmed postoperative infection [OR=1.82, 95%CI (1.18, 2.82), P=0.007], suspected infection [OR=1.60, 95%CI (1.11, 2.30), P=0.012] and total infection [OR=1.64, 95%CI (1.20, 2.24), P=0.002]. The results of modified Poisson regression analysis showed that there was no significant association between preoperative anemia and death within 90 days after the surgery [RR=1.59, 95%CI (0.69, 3.69), P=0.276]. Conclusion Preoperative anemia may be a risk factor for infection after elective cardiac surgery in children with acyanotic congenital heart disease.