Cavalcante Candice Torres de Melo Bezerra, de Souza Nayana Maria Gomes, Pinto Valdester Cavalcante, Branco Klébia Magalhães Pereira Castello, Pompeu Ronald Guedes, Teles Andreia Consuelo de Oliveira, Cavalcante Rodrigo Cardoso, de Andrade Giselle Viana
Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
Braz J Cardiovasc Surg. 2016 May-Jun;31(3):219-225. doi: 10.5935/1678-9741.20160022.
Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease.
To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period.
A retrospective date analysis was performed from January 2003 to December 2014. The survey was divided in two periods of six years long each, to check for any improvement in the results. We evaluated the numbers of procedures performed, complexity of surgery and hospital mortality.
Three thousand and two hundred and one surgeries were performed. Of these, 3071 were able to be classified according to the score RACHS-1. Among the patients, 51.7% were male and 47.5% were younger than one year of age. The most common RACHS-1 category was 3 (35.5%). The mortality was 1.8%, 5.5%, 14.9%, 32.5% and 68.6% for category 1, 2, 3, 4 and 6, respectively. There was a significant increase in the number of surgeries (48%) and a significant reduction in the mortality in the last period analysed (13.3% in period I and 10.4% in period II; P=0.014).
RACHS-1 score was a useful score for mortality risk in our service, although we are aware that other factors have an impact on the total mortality.
先天性心脏病手术风险调整1（RACHS - 1）评分是一种简单且易于应用的模型，已被广泛用于儿科心血管服务之间的死亡率比较。它基于几种外科姑息或矫正手术的分类，这些手术在先天性心脏病治疗中的死亡率相似。
分析12年间基于RACHS - 1评分的18岁以下先天性心脏病患儿心脏手术的院内死亡率。
对2003年1月至2014年12月进行回顾性数据分析。调查分为两个为期六年的时间段，以检查结果是否有任何改善。我们评估了手术数量、手术复杂性和医院死亡率。
共进行了3201例手术。其中，3071例能够根据RACHS - 1评分进行分类。患者中，51.7%为男性，47.5%年龄小于1岁。最常见的RACHS - 1类别是3类（35.5%）。1、2、3、4和6类的死亡率分别为1.8%、5.5%、14.9%、32.5%和68.6%。在分析的最后一个时间段，手术数量显著增加（48%），死亡率显著降低（第一阶段为13.3%，第二阶段为10.4%；P = 0.014）。
RACHS - 1评分对我们服务中的死亡风险是一个有用的评分，尽管我们知道其他因素会对总死亡率产生影响。
