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Survival after surgery for congenital heart defects: Does reduced early mortality predict improved long‐term survival?
Author(s) -
Eskedal Leif,
Skjalg Hagemo Peter,
Eskild Anne,
Aamodt Geir,
Seiler Kerry S,
Thaulow Erik
Publication year - 2005
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2005.tb01915.x
Subject(s) - medicine , retrospective cohort study , cohort , cardiac surgery , surgery , survival rate , population , survival analysis , pediatrics , environmental health
Aim: The objectives of this study were 1) to compare early mortality (first 30 d after surgery) and long‐term survival between two cohorts of patients operated on for congenital cardiac defects, and 2) to evaluate the impact of possible changes in early mortality on long‐term survival. Methods: 945 patients with congenital cardiac defects, born in 1990–1999 and operated on in the same period were examined in a retrospective cohort study. The patients were divided into three groups: “univentricular cardiac defects”, “severe cardiac defects” and “less severe cardiac defects”. The study population was divided into two cohorts: group 1 included patients born and operated on in 1990–1994; group 2 included patients born and operated on in 1995–1999. The survival patterns in the two groups were compared. Results: For all patients, except those with univentricular cardiac defects, early mortality (30 d after surgery) was reduced. Among patients with severe cardiac defects, early mortality was reduced from 18.6% in group 1 to 2.9% in group 2. Among patients with less severe cardiac defects, early mortality was reduced from 6.2% to 1.9%. The improved outcome was maintained during the following 5 y. Overall relative risk of death during follow‐up was reduced to 0.31 (95% CI: 0.15–0.56) for patients with severe cardiac defects, and to 0.53 (95% CI: 0.31–0.93) for patients with less severe cardiac defects born and operated on in 1995–1999. Conclusion: Early mortality has been substantially reduced in congenital heart defect patients, and corresponds with significantly improved long‐term survival.