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Preoperative percutaneous oxygen saturation is a predictor of postoperative adverse events after Ebstein's anomaly reconstruction
  • +6
  • Yao Yang,
  • Wei Zhang,
  • Yang Liu,
  • Gang Li,
  • Han Zhang,
  • Xing Fan,
  • Junwu Su,
  • Yinglong Liu,
  • Xiangming Fan
Yao Yang
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Wei Zhang
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Yang Liu
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Gang Li
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Han Zhang
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Xing Fan
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Junwu Su
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Yinglong Liu
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Xiangming Fan
Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100029, China.
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Abstract

Background Ebstein’s anomaly (EA) is a kind of congenital heart disease, which is currently widely treated by cone reconstruction. However, prediction of postoperative recovery is still challenging. Methods A retrospective analysis was performed on EA cases undergoing cone reconstruction from January 2010 to January 2016. Univariate and multivariate logistic regression analyses were performed, with postoperative adverse events defined as dependent variable and pre- and intra-operative parameters defined as independent variables. Predictive capacity of preoperative SPO2 and Great Ormond Street (GOS) score was evaluated using areas under the curve of receiver operating characteristic (ROC). Results Preoperative SPO2 was 95.7 ± 5.20%. Cardiopulmonary bypass, aortic cross-clamp, postoperative mechanical ventilation, and hospitalization time were 101.7 ± 28.26 min, 60.9 ± 18.04 min, 16 hours (8, 22), and 8 days (7, 11), respectively. The incidence of total postoperative adverse events including low cardiac output syndrome, mechanical ventilation more than 3 days, postoperative hospitalization more than 2 weeks, postoperative re-intubation, extracorporeal membrane oxygenation assistance, and death was 13.1% (n=13). Low pre-operative SPO2 (P=0.001, OR=0.834), GOS score (P=0.021, OR=0.368), and cardiopulmonary bypass time (P=0.034, OR=1.021) were risk factors for adverse events. Multivariate logistic regression analysis showed that low preoperative SPO2 (P=0.002, OR=0.846) and GOS score (P=0.043, OR=0.577) were independent risk factors for adverse events. The areas of SPO2 and GOS score under the ROC curve were 0.764 and 0.740, respectively. Conclusions Low pre-operative SPO2 and GOS score were predictors of adverse events after cone reconstruction, and SPO2 was more convenient and objective than GOS score.

Peer review status:ACCEPTED

28 Nov 2020Submitted to Journal of Cardiac Surgery
14 Dec 2020Assigned to Editor
14 Dec 2020Submission Checks Completed
14 Dec 2020Reviewer(s) Assigned
31 Dec 2020Review(s) Completed, Editorial Evaluation Pending
31 Dec 2020Editorial Decision: Accept