Short-term outcomes and risk factors for mortality in neonatal cardiac surgeries with cardiopulmonary bypass: a 5-year single-center report.

BACKGROUND

Open-heart surgeries carry significantly greater risks in neonates than in older children. The current study aimed to analyze the short-term outcomes and risk factors for mortality in neonates undergoing cardiac surgeries.

METHODS

This retrospective analysis included neonates who underwent cardiac surgeries with cardiopulmonary bypass (CPB) at our center between 2019 and 2023. Perioperative and operative factors were collected, and in-hospital outcomes and risk factors for mortality were identified.

RESULTS

We analyzed the medical records of 190 neonates, including 111 males and 79 females. The median age at the time of surgery was 15 days, with a median weight of 3.2 kg. The overall mortality rate was 11.6%. Major postoperative complications included infection (48.9%), low cardiac output (48.4%), hepatic insufficiency (24.9%), acute kidney injury (22.1%), unplanned reintervention (13.1%), intracranial hemorrhage (3.7%), and cerebral infarction (0.5%). Multivariable analysis identified prolonged CPB time (odds ratio (OR)=1.018, p=0.014), Risk Stratification for Congenital Heart Surgery (RASCH-2) categories of ≥4 (OR=11.927, p=0.026), extracorporeal membrane oxygenation (ECMO) duration (OR=1.606, p=0.036), and peritoneal hemodialysis (OR=9.252, p=0.014) as significant predictors for mortality.

CONCLUSIONS

Despite advancements in recent decades, continued vigilance is required to further reduce mortality rates among neonates undergoing cardiac surgeries.