Outcomes for Indigenous children undergoing cardiac surgery

Abstract

Background: Previous studies of surgical outcomes for indigenous children have suggested that the early outcomes are comparable to that for the non-Indigenous population, but no reliable longer-term outcome information is available. Methods: Indigenous children with acquired or congenital heart disease who underwent cardiac surgery between May 2008 and August 2014 were studied. Demographic information, diagnosis and comorbidities, treatment and outcome data were collected at time of surgery and at clinical followup. Results: 128 children with a median age of 0.8 years (0-16.3 years) underwent 176 surgical procedures. The mean comprehensive Aristotle Score of the primary procedure was 9.2+4.3. Eleven (8.6%) operations were related to rheumatic carditis. The median follow-up was 22.5 months (1-80 months). Follow up was complete for 120 (93.8%) patients. There were 3 (2.3%) early deaths and 7 (5.5%) late deaths during the followup period (Figure). The cause of death was cardiac related in 9 (7.0%) and non-cardiac in one patient. Non-cardiac issues identified during follow-up included poor compliance with medications (n=5, 4.2%), substance abuse (n=2, 1.7%) and unplanned pregnancy (n=2, 1.7%). (Graph presented) Conclusion: High rates of follow-up can be achieved for a decentralised indigenous cardiac population. Early surgical mortality is low, but there is a late mortality and other social contributing factors that require further assessment.L721035592015-12-10 <br />