Abdshah Alireza, Mirzaaghayan Mohammadreza, Heidari Morteza, Memarian Sara, Amanollahi Mobina, Nazeri Azadeh, Gharib Behdad
School of Medicine Tehran University of Medical Sciences Tehran Iran.
Department of Public Health Sciences, Division of Biostatistics University of Miami Miller School of Medicine Miami Florida USA.
Health Sci Rep. 2023 Jan 18;6(1):e1077. doi: 10.1002/hsr2.1077. eCollection 2023 Jan.
Due to increased rate of open-heart surgeries in children, postsurgical mortality and morbidities have increasingly gained attention. Neurological complications are some of the most important postsurgical events. However, the number of studies regarding postsurgical neurological complications seems to be inadequate. We aimed to study the incidence of neurological complications following cardiac surgery in the pediatric cardiac intensive care unit (ICU) of the children's medical center.
This cross-sectional study was conducted from March to September 2019. We included all of the children who underwent cardiac surgery and were admitted to ICU at CMC. We collected their demographic data, lab test results (white blood cell count, absolute neutrophile and lymphocyte counts) and calculated their Risk Adjustment for Congenital Heart Surgery (RACHS) score. We then documented neurological adverse events and investigated the associations between those events and the patients' data.
Of the 267 studied patients, 14 developed neurological complications (5.2%); seven developed chorea (2.6%), four developed seizures (1.5%), and two developed both seizure and chorea (0.7%). One case developed subarachnoid hemorrhage (SAH). We observed that age ( = 0.000), weight ( = 0.000), and RACHS score ( = 0.006) were associated with the development of neurological complications. Additionally, we observed that "neutrophil to lymphocyte ratio" was not associated with the risk of postsurgical neurological complications.
Younger age, lower weight, and higher RACHS score were associated with neurological complications after operations. Given the importance of postsurgical neurological complications, further investigations should be carried out to cover this issue and discover preventive strategies for such morbidities.
由于儿童心脏直视手术的发生率增加，术后死亡率和发病率越来越受到关注。神经并发症是一些最重要的术后事件。然而，关于术后神经并发症的研究数量似乎不足。我们旨在研究儿童医学中心儿科心脏重症监护病房（ICU）心脏手术后神经并发症的发生率。
这项横断面研究于2019年3月至9月进行。我们纳入了所有在CMC接受心脏手术并入住ICU的儿童。我们收集了他们的人口统计学数据、实验室检查结果（白细胞计数、绝对中性粒细胞和淋巴细胞计数），并计算了他们的先天性心脏病手术风险调整（RACHS）评分。然后，我们记录了神经不良事件，并调查了这些事件与患者数据之间的关联。
在267例研究患者中，14例发生神经并发症（5.2%）；7例发生舞蹈症（2.6%），4例发生癫痫（1.5%），2例同时发生癫痫和舞蹈症（0.7%）。1例发生蛛网膜下腔出血（SAH）。我们观察到年龄（P = 0.000）、体重（P = 0.000）和RACHS评分（P = 0.006）与神经并发症的发生有关。此外，我们观察到“中性粒细胞与淋巴细胞比值”与术后神经并发症的风险无关。
年龄较小、体重较低和RACHS评分较高与术后神经并发症有关。鉴于术后神经并发症的重要性，应进一步开展研究以涵盖这一问题，并发现针对此类疾病的预防策略。
