Abstract Ref Number = APCP213
PREDICTORS OF MORTALITY IN NEONATES WITH DUCT-DEPENDENT CRITICAL CONGENITAL HEART DISEASE
Irma Sri Hidayati,Indah Kartika murni,Sasmito Nugroho,Noormanto ,Tunjung Wibowo
Department of Child Health Faculty of Medicine Public Health and Nursing Universitas Gadjah Mada DR Sardjito Hospital Yogyakarta Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah MadaDR Sardjito Hospital Yogyakarta
Background : Duct-dependent critical congenital heart disease requires intervention during the first month of life, occurring approximately 25% of those with congenital heart disease. Delay in diagnosis and treatment can cause increased significant mortality and morbidity for survivors. This study aimed to evaluate predictors of mortality in neonates with duct-dependent critical congenital heart disease.
Material : We conducted a retrospective cohort study among neonates with duct-dependent critical congenital heart disease in Neonatal Intensive Care Unit (NICU) Dr. Sardjito general hospital from January 2015 to June 2017. Diagnosis were confirmed using echocardiography. Predictors of mortality included gender, age at admission, maternal age, birth weight, mode of delivery, sepsis, presence of associated syndrome, use of prostaglandin, invasive oxygen therapy and palliative procedure including balloon atrial septostomy (BAS) or Blalock-Taussig (BT) shunt. Regression logistic was used to investigate independent predictor of mortality in neonates with duct-dependent critical congenital heart disease.
Results : We analyzed 24 patients with duct-dependent critical congenital heart disease, of those 10 patients (42%) died. There were 18 patients (75%) had duct-dependent pulmonary circulation, 2 patients (8.3%) had duct-dependent systemic circulation, and 4 patients (16.7%) had parallel circulation mixing. On bivariate analysis, clinical characteristics that were significant different in mortality were birth weight, sepsis, and invasive oxygen therapy. Independent predictors of mortality were identified using multivariate logistic regression. Sepsis was the only significant predictor for mortality (relative risk = 3.3, 95% confidence interval: 1.08-47.96, P = 0.04).
Conclusions : Sepsis was identified as an independent predictor of mortality in neonates with duct-dependent critical congenital heart disease.
Keywords: duct-dependent congenital heart disease prognosis neonates