Castellheim Albert Gyllencreutz, Habre Walid, Hansen Tom Giedsing
Department of Anesthesiology and Intensive Care Medicine, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Anaesthesiol Scand. 2025 Mar;69(3):e14585. doi: 10.1111/aas.14585.
Despite advancements in surgical techniques and perioperative care, pediatric cardiac patients remain at an increased risk of adverse events. The APRICOT (2017) study aimed to establish the incidence of severe critical events in children undergoing anesthesia in Europe, while the NECTARINE (2021) study aimed to assess anesthesia practices and outcomes in neonates and infants under 60 weeks postconceptual age. Our goal was to conduct a secondary analysis of the cardiac cohorts from these two studies to determine mortality rates and other outcomes after cardiac procedures at 30 and 90 days, identify factors influencing mortality, illustrate clinical practices, and assess the methodology of the two studies.
Sub-analysis of the data from APRICOT and NECTARINE. Data representativity was assessed through a systematic categorization process. European countries were divided into four income groups based on their gross national income per capita. Subsequently, the total number of patients across all four income groups was calculated for both the Apricot and Nectarine studies, and then the specific contribution of each income group to the total population of each study was determined.
This analysis comprised 1016 cases (Apricot, n = 476 and Nectarine, n = 540). There was a considerable variability in clinical practice in Europe. The overall mortality rates were 0.84% (APRICOT) and 8.1% (NECTARINE). In both cohorts, substantial mortality was observed among low-age and low-weight infants. Stratifying the participating countries by income illustrated that the data originated from highest-income and upper-middle-income European countries and were not representative of low-income and middle-income countries.
In this secondary analysis of the APRICOT and NECTARINE studies, we found that fatal cases primarily occurred in low-age and low-weight neonates and infants.
This secondary analysis of the APRICOT and NECTARINE studies focused on pediatric cardiac surgical cases. Outcomes differed according to weight and age of the children, where mortality risk was higher for very young and low-weight children.
尽管手术技术和围手术期护理有所进步，但小儿心脏疾病患者发生不良事件的风险仍然较高。APRICOT（2017年）研究旨在确定欧洲接受麻醉的儿童中严重危急事件的发生率，而NECTARINE（2021年）研究旨在评估孕龄60周以下新生儿和婴儿的麻醉实践及结局。我们的目标是对这两项研究中的心脏队列进行二次分析，以确定心脏手术后30天和90天的死亡率及其他结局，识别影响死亡率的因素，阐述临床实践，并评估这两项研究的方法。
对APRICOT和NECTARINE的数据进行亚分析。通过系统分类过程评估数据代表性。欧洲国家根据人均国民总收入分为四个收入组。随后，计算APRICOT和NECTARINE研究中所有四个收入组的患者总数，然后确定每个收入组对每项研究总人口的具体贡献。
该分析包括1016例病例（APRICOT组476例，NECTARINE组540例）。欧洲的临床实践存在很大差异。总体死亡率分别为0.84%（APRICOT）和8.1%（NECTARINE）。在两个队列中，低龄和低体重婴儿的死亡率都很高。按收入对参与国家进行分层表明，数据来自欧洲高收入和中高收入国家，不代表低收入和中等收入国家。
在对APRICOT和NECTARINE研究的这项二次分析中，我们发现致命病例主要发生在低龄和低体重的新生儿及婴儿中。
对APRICOT和NECTARINE研究的这项二次分析聚焦于小儿心脏手术病例。结局因儿童的体重和年龄而异，极低龄和低体重儿童的死亡风险更高。
