Nina Rachel Vilela de Abreu Haickel, Gama Mônica Elinor Alves, Santos Alcione Miranda dos, Nina Vinícius José da Silva, Figueiredo Neto José Albuquerque de, Mendes Vinícius Giuliano Gonçalves, Lamy Zeni Carvalho, Brito Luciane Maria de Oliveira
UFMA University Hospital.
Rev Bras Cir Cardiovasc. 2007 Oct-Dec;22(4):425-31. doi: 10.1590/s0102-76382007000400008.
The aim of this study was to evaluate the applicability of the RACHS-1 (Risk Adjustment in Congenital Heart Surgery) as a predictor of surgical mortality in a pediatric population of a public hospital of the Northeast of Brazil.
From June 2001 through June 2004, 145 patients undergone surgical treatment of CHD in our institution of whom 62% were female, and the mean age was 5.1 years. The RACHS-1 was used to classify the surgical procedures into categories of risk 1 to 6, and logistic regression analysis was used to identify the risk factors related to surgical death.
Age, type of CHD, pulmonary flow, surgical procedure, pump time and cross clamp time were identified as a risk factor for postoperative mortality (p<0.001). There was a linear correlation between the categories of the RACHS-1 and the mortality rate; however, the observed mortality was greater than the predicted figures by that scoring system.
Although the RACHS-1 is easily applicable, it can not be applicable in our scenario because it takes into account only the surgical procedure as a categorized variable, not considering others factors presented in our scenario that could interfere in the final surgical result.
本研究旨在评估RACHS-1（先天性心脏病手术风险调整）作为巴西东北部一家公立医院儿科人群手术死亡率预测指标的适用性。
2001年6月至2004年6月，我院145例患者接受了先天性心脏病手术治疗，其中62%为女性，平均年龄为5.1岁。采用RACHS-1将手术程序分为1至6级风险类别，并采用逻辑回归分析确定与手术死亡相关的风险因素。
年龄、先天性心脏病类型、肺血流量、手术程序、体外循环时间和主动脉阻断时间被确定为术后死亡的风险因素（p<0.001）。RACHS-1分级与死亡率之间存在线性相关性；然而，观察到的死亡率高于该评分系统预测的数字。
尽管RACHS-1易于应用，但在我们的情况下不适用，因为它仅将手术程序作为分类变量考虑，而未考虑我们研究中可能影响最终手术结果的其他因素。
