18:15 〜 19:15
[II-JCKEOP01-02] Postoperative mortality and respiratory complications in CHD patients with heterotaxy and their relationship with ciliary dysfunction
Recent studies have revealed an association among heterotaxy, congenital heart disease, and primary ciliary dyskinesia (PCD). Thus airway ciliary dysfunction (CD) similar to that of PCD may have relevance for increased respiratory complications in heterotaxy patients. Thus we explore the mortality and respiratory complications in heterotaxy patients as compared to CHD patients without heterotaxy in china.
A retrospective review of patients undergoing cardiac surgery was undertaken at our hospiatl between Jan, 1st, 2008 and Dec, 31th, 2014, which was performed on postsurgical outcomes of 137 patients with heterotaxy and congenital heart disease exhibiting the full spectrum of situs abnormalities associated with heterotaxy. As controls patients, 881 cardiac surgical patients with congenital heart disease, but without laterality defects, were selected.
We found the postsurgical deaths (16.9% vs 4.4%; OR, 3.2), mean length of postoperative hospital stay (12.5 vs 9.2 days; OR, 3.1), mechanical ventilation(58 vs 41 hours; OR, 3.2) and ICU stay (92 vs 73 hours; OR, 2.3) were significantly increased in the heterotaxy patients. Also elevated were number of reintubation (1.6 vs 1.1 hours; OR, 3.3) ,salvage (11.4% vs 5.2%: OR, 2.2) and fever (66.4% vs 34.9%; OR, 3.7).
Our findings show heterotaxy patients had more postsurgical events with increased postsurgical mortality and risk for respiratory complications as compared to control patients. We speculate that some respiratory defects may contribute to the increased mortaliy and respiratory complications in heterotaxy patients.
A retrospective review of patients undergoing cardiac surgery was undertaken at our hospiatl between Jan, 1st, 2008 and Dec, 31th, 2014, which was performed on postsurgical outcomes of 137 patients with heterotaxy and congenital heart disease exhibiting the full spectrum of situs abnormalities associated with heterotaxy. As controls patients, 881 cardiac surgical patients with congenital heart disease, but without laterality defects, were selected.
We found the postsurgical deaths (16.9% vs 4.4%; OR, 3.2), mean length of postoperative hospital stay (12.5 vs 9.2 days; OR, 3.1), mechanical ventilation(58 vs 41 hours; OR, 3.2) and ICU stay (92 vs 73 hours; OR, 2.3) were significantly increased in the heterotaxy patients. Also elevated were number of reintubation (1.6 vs 1.1 hours; OR, 3.3) ,salvage (11.4% vs 5.2%: OR, 2.2) and fever (66.4% vs 34.9%; OR, 3.7).
Our findings show heterotaxy patients had more postsurgical events with increased postsurgical mortality and risk for respiratory complications as compared to control patients. We speculate that some respiratory defects may contribute to the increased mortaliy and respiratory complications in heterotaxy patients.