Leite Debora Cristina Fontes, de Mendonça José Teles, Cipolotti Rosana, de Melo Enaldo Viera
Federal University of Sergipe, Santa Isabel Maternity Neonatal Intensive Care Unit, Aracaju, Brazil.
Rev Bras Cir Cardiovasc. 2012 Apr-Jun;27(2):224-30. doi: 10.5935/1678-9741.20120038.
This study aims evaluate the treatment of congenital heart disease conducted from 2000 to 2009.
The sample consisted of all patients undergoing surgical correction for congenital heart disease for ten years in Sergipe, Brazil. The patients were operated in three hospitals located in the city of Aracaju, capital of the state of Sergipe (Brazil). The study was divided into two periods defined by the start date of centralization of surgery. The variables collected were: age, sex, postoperative diagnosis, destination, type of surgery and hospital where the procedure was performed and the classification RACHS -1.
In the period I, the estimate deficit of surgery was 69% decrease occurring in the period II to 55.3%. The postoperative diagnosis was more frequent closure of the interventricular communication (20.5%), closure of patent ductus arteriosus (20.2%) and atrial septal defect (19%). There was a statistically significant correlation between the expected mortality RACHS-1 and observed in the sample. The evaluation of RACHS-1 as a predictor of hospital mortality by ROC curve showed area of 0.860 95% CI 0.818 to 0.902 with P <0.0001.
The results of this study indicate that the centralization and organization of existing resources are needed to improve the performance of surgical correction of congenital heart diseases.
本研究旨在评估2000年至2009年期间对先天性心脏病的治疗情况。
样本包括巴西塞尔希培州所有在十年间接受先天性心脏病手术矫正的患者。这些患者在塞尔希培州首府阿拉卡茹市的三家医院接受手术。该研究根据手术集中化的起始日期分为两个时期。收集的变量包括：年龄、性别、术后诊断、去向、手术类型、进行手术的医院以及RACHS-1分类。
在第一阶段，手术估计缺口为69%，在第二阶段降至55.3%。术后诊断中最常见的是室间隔缺损闭合（20.5%）、动脉导管未闭闭合（20.2%）和房间隔缺损（19%）。RACHS-1预期死亡率与样本中观察到的死亡率之间存在统计学显著相关性。通过ROC曲线评估RACHS-1作为医院死亡率预测指标，其面积为0.860，95%置信区间为0.818至0.902，P<0.0001。
本研究结果表明，需要集中和组织现有资源以提高先天性心脏病手术矫正的效果。
