Phenotypic profile and predictors of adverse outcomes during paediatric cardiac catheterisation at an academic hospital, South Africa - Summary - MDSpire
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Phenotypic profile and predictors of adverse outcomes during paediatric cardiac catheterisation at an academic hospital, South Africa
To describe the demographic and clinical profile, determine adverse outcomes, and identify predictors of complications among children undergoing cardiac catheterization.
Approach:
Study Design: Retrospective cohort study conducted on children aged 0–18 years with congenital heart disease who underwent cardiac catheterization from January 2018 to December 2022.
Data Collection: Patient data was obtained from the cardiac catheterization laboratory, anaesthetic records, and the paediatric cardiac database.
Data Analysis: Descriptive and multivariate regression data analysis were performed.
Key Findings:
597 pediatric cardiac catheterization procedures were analyzed.
Median age was 1.8 (IQR 0.8–4.0) years; 52% were male.
66% were on anti-failure treatment; 40% had pulmonary hypertension.
CRISP score significantly associated with complications (AOR 1.21, 95% CI 1.10–1.33, p < 0.001).
Age <1 year predictive of complications (AOR 1.83, 95% CI 1.11–3.01, p = 0.018).
Presence of congenital syndrome associated with increased odds of complications (AOR 1.72, 95% CI 1.10–2.67, p = 0.016).
Peri-operative inotropes (AOR 18.3, 95% CI 6.05–70.0, p < 0.001), beta blockers (AOR 2.43, 95% CI 1.28–4.54, p = 0.006), and prostin (AOR 0.25, 95% CI 0.07–0.80, p = 0.025) were associated with complications.
Mortality rate in the cohort was 0.8%; pulmonary hypertension was not associated with increased perioperative complications.
Interpretation:
The study indicates that pediatric cardiac catheterization procedures in a resource-limited South African setting involve a diverse patient population with significant health challenges, yet the incidence of severe adverse outcomes remains low.
Limitations:
Retrospective design may limit the comprehensiveness of data.
Potential for missing records and selection bias.
Conclusion:
The findings support the feasibility and safety of pediatric cardiac catheterization in a high-burden, resource-limited setting when managed by an experienced multidisciplinary team.
