Survival and Associated Risk Factors for Mortality Among Infants with Critical Congenital Heart Disease in a Developing Country

• Published in: Pediatric cardiology 2018-10, Vol.39 (7), p.1389-1396
• Main Authors: Mat Bah, Mohd Nizam, Sapian, Mohd Hanafi, Jamil, Mohammad Tamim, Alias, Amelia, Zahari, Norazah
• Format: Article
• Language: English
• Subjects: Cardiac Surgery; Cardiology; Cohort Studies; Congenital heart disease; Developing Countries; Female; Genetic disorders; Health aspects; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - mortality; Heart diseases; Humans; Infant; Infant Mortality; Infants; Kaplan-Meier Estimate; Malaysia; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Mortality; Original Article; Proportional Hazards Models; Retrospective Studies; Risk Factors; Survival Rate; Vascular Surgery
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-018-1908-6

Critical congenital heart disease (CCHD) is associated with significant morbidity and mortality. However, data on survival of CCHD and the risk factors associated with its mortality are limited. This study examined CCHD survival and the risk factors for CCHD mortality. Using a retrospective cohort study of infants born with CCHD from 2006 to 2015, survival over 10 years was estimated using Kaplan–Meier analysis, and the risk factors for mortality were analyzed using multivariate Cox proportional hazards regression. A total of 491 CCHD cases were included in the study, with an overall mortality rate of 34.8% (95% confidence interval [CI] 30.6–39.2). The intervention/surgical mortality rate was 9.8% ≤ 30 days and 11.5% > 30 days after surgery, and 17% died before surgery or intervention. The median age at death was 2.7 months [first quartile: 1 month, third quartile: 7.3 months]. The CCHD survival rate was 90.4% (95% CI 89–91.8%) at 1 month, 69.3% (95% CI 67.2–71.4%) at 1 year, 63.4% (95% CI 61.1–65.7%) at 5 years, and 61.4% (95% CI 58.9–63.9%) at 10 years. Weight of