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Paediatric structural heart diseases are an important cause of morbidity and mortality especially in developing countries where late presentation and delayed diagnosis and treatment is common. The aim of this study was to describe the pattern of structural heart diseases in children seen in the Paediatric Cardiology Unit of a tertiary hospital in Bayelsa State Nigeria and identify the predictors of mortality among those who died over the study period. It was a retrospective review of cases seen in the paediatric cardiology unit and subsequently followed up over a 7-year period (1st April 2013 to 31st March 2020). Sociodemographic data, clinical features and echocardiographic findings as well as details of their outcome were documented. Data was imputed into an Excel spread sheet and analyzed using SPSS 22.0. Binary logistic regression was performed to determine the risk factors for mortality. Of the 175 children seen by the Cardiology Unit over the study period, 92 (52.6%) had structural heart diseases. The mean age of the children was 39.4±56.2 months with a male: female ratio of 1.6:1. Congenital heart diseases (CHD) were noted in 92% of cases with Atrial septal defects (ASD), followed by Ventricular Septal defects (VSD) and Patent Ductus Arteriosus (PDA) being the most prevalent CHD seen. The combination of ASD/VSD/PDA was the most common multiple structural defect noted. Acquired heart diseases including Rheumatic heart disease and Dilated cardiomyopathy were reported in 8% of cases. Mortalities were recorded in 20 children (21.7%) with most of the deaths occurring as a result of intractable heart failure. Mortality was significantly associated with the third birth order (OR-4.63; p-0.021), fast breathing (OR-2.15; p-0.006), presence of heart failure (OR-3.16; p-0.026), failure to thrive (OR-2.93; p-0.036), use of cardiac medications (OR-6.91; 0.0013) and CHD with multiple structural defects (OR-11.44; p-0.006).

cardiology and cardiovascular research

Pattern of Structural Heart Disease and Predictors of Mortality Among Affected Children Seen at the Niger Delta University Teaching Hospital Bayelsa State