AlAshgar Tala M, AlDawsari Norah H, AlSanea Nasreen Y, AlSalamah Noura A, AlSugair Nada S, Ardah Husam I, Kabbani Mohamed S
Medicine and Surgery, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU.
Biostatistics and Epidemiology, King Abdullah International Medical Research Center, Riyadh, SAU.
Cureus. 2024 Feb 28;16(2):e55186. doi: 10.7759/cureus.55186. eCollection 2024 Feb.
Background DiGeorge syndrome, a common genetic microdeletion syndrome, is associated with multiple congenital anomalies, including congenital cardiac diseases. This study aims to identify the short and midterm outcomes of cardiac surgery performed on children with DiGeorge syndrome. Methods A retrospective cohort study was conducted between the period of 2018-2022, which included children divided into two groups with a 1:2 ratio. Group one included DiGeorge syndrome patients who were diagnosed using fluorescence in situ hybridization (FISH). Group two included the control group of patients who were clear of genetic syndromes. The two groups were matched based on similar cardiac surgery, age of surgery, and Risk Adjustment in Congenital Heart Surgery (RACHS-1) score. The two groups were compared based on the demographical data and postoperative complications. Results The study consisted of 81 children; 27 were DiGeorge syndrome patients, and 54 were in the control group. DiGeorge syndrome patients showed an increase in mechanical ventilation duration (p=0.0047), intensive care unit (ICU) length of stay (p=0.0012), and hospital length of stay (p=0.0391). Moreover, they showed an increased risk for bacteremia (p=0.0414), ventilator-associated pneumonia (VAP; p=0.0036), urinary tract infections (UTI; p=0.0064), and surgical site infection (SSI; p≤0.0001). They were also more susceptible to postoperative seizures (p=0.0049). Furthermore, patients with DiGeorge syndrome had a higher prevalence of congenital renal anomalies. However, there was no mortality in either group. Conclusion This study shows a variability in the postoperative outcomes between the two groups. The study demonstrates that patients with DiGeorge syndrome have higher risks of infections and longer hospital stay during the postoperative period. Further research with a larger sample is needed to confirm our findings.
迪乔治综合征是一种常见的基因微缺失综合征,与多种先天性异常有关,包括先天性心脏病。本研究旨在确定对迪乔治综合征患儿进行心脏手术的短期和中期结果。方法:进行了一项回顾性队列研究,时间跨度为2018年至2022年,研究对象为儿童,分为两组,比例为1:2。第一组包括使用荧光原位杂交(FISH)诊断的迪乔治综合征患者。第二组为无基因综合征的对照组患者。两组根据相似的心脏手术、手术年龄和先天性心脏病手术风险调整(RACHS-1)评分进行匹配。根据人口统计学数据和术后并发症对两组进行比较。结果:该研究共纳入81名儿童;27名是迪乔治综合征患者,54名在对照组。迪乔治综合征患者的机械通气时间(p=0.0047)、重症监护病房(ICU)住院时间(p=0.0012)和住院时间(p=0.0391)均增加。此外,他们发生菌血症(p=0.0414)、呼吸机相关性肺炎(VAP;p=0.0036)、尿路感染(UTI;p=0.0064)和手术部位感染(SSI;p≤0.0001)的风险增加。他们术后癫痫发作的易感性也更高(p=0.0049)。此外,迪乔治综合征患者先天性肾脏异常的患病率更高。然而,两组均无死亡病例。结论:本研究表明两组术后结果存在差异。该研究表明,迪乔治综合征患者术后感染风险更高,住院时间更长。需要进一步进行更大样本量的研究来证实我们的发现。