DeWitt et al evaluated pediatric patients who underwent surgery for congenital heart disease. They identified risk factors for mortality as well as prolonged ICU care. The authors are from Children's Hospital of Philadelphia, University of Utah, Texas Children's Hospital, Emory University, University of Toronto and University of Michigan.
Patient selection: surgery for congenital heart disease. Neonates were 4 to 11 days old. Nonneonates were 5 to 93 months old, in theory to 18 years.
General risk factors:
(1) renal replacement therapy for acute renal failure
(2) prolonged postoperative ventilator days
(3) unplanned reoperation
(4) cardiac arrest
Additional risk factors for a neonate:
(1) need for vasoactive agents
Additional risk factors for non-neonates:
(1) use of inhaled nitric oxide
(2) mechanical circulatory support
(3) any preoperative Society of Thoracic Surgery risk factors
Most of these risk factors reflect organ failures.
The risk of mortality increases with the number and severity of the risk factors.
