孤立性新生儿室间隔缺损的存活率和预后:一项基于中等收入国家人口的研究。

IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Annals of Pediatric Cardiology Pub Date : 2023-09-01 Epub Date: 2024-04-01 DOI:10.4103/apc.apc_130_23
Mohd Nizam Mat Bah, Mohd Hanafi Sapian, Mohd Hazman Mohd Anuar, Emieliyuza Yusnita Alias
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引用次数: 0

摘要

背景和目的:有关中等收入国家室间隔缺损(VSD)存活率和预后的数据有限。因此,本研究旨在确定新生儿 VSD 的存活率以及与死亡率相关的因素:这是一项基于人群的回顾性研究,研究对象为2009年至2019年间出生的患有孤立性VSD的新生儿。采用 Kaplan-Meier 分析法估算总体存活率。Cox回归分析用于确定与死亡率相关的因素:共有726名患者接受了研究,其中82人(11%)患有21三体综合征。诊断和随访的中位年龄分别为 5 天(四分位间距 [IQR]:2-10 天)和 2.3 年(IQR:0.6-4.8 年)。在 726 例患者中,399 例(55%)为包膜型 VSD,218 例(30%)为肌型 VSD,109 例(15%)为出口型 VSD。309例(42%)VSD为小,337例(46%)为中,80例(11%)为大。在 726 名患者中,189 人(26%)患有充血性心力衰竭(CHF),52 人(7.2%)出现肺动脉高压(PHT)。有趣的是,三分之一的充血性心力衰竭和肺动脉高压在随访期间逐渐缓解。只有 1 名(0.1%)患者患有感染性心内膜炎,38 名(5.2%)患者出现主动脉瓣反流,没有人患有艾森曼格综合征。总体而言,149 例(20%)需要手术,399 例(55%)自然闭合,178 例(25%)仍然很小。死亡率为3.9%(28例),其中16例(57%)在术前死亡,11例(39%)因肺炎死亡。21 三体综合征、PHT 和出生体重 结论:尽管中等收入国家的儿科和先天性心脏病服务有限,但新生儿 VSD 的总体存活率较高,小婴儿、PHT 和 21 三体综合征的预后较差。
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Survival and outcomes of isolated neonatal ventricular septal defects: A population-based study from a middle-income country.

Background and aims: Limited data on the survival and outcomes of ventricular septal defect (VSD) in middle-income countries are available. Hence, this study aims to determine the survival and factors associated with mortality among neonatal VSD.

Materials and methods: This is a retrospective, population based study of neonates with isolated VSD born between 2009 and 2019. Kaplan-Meier analysis was used to estimate the overall survival. Cox regression analysis was used to determine factors associated with mortality.

Results: There were 726 patients studied, with 82 (11%) of them having trisomy 21. The median age of diagnosis and follow-up was 5 days (interquartile range [IQR]: 2-10 days) and 2.3 years (IQR: 0.6-4.8 years), respectively. Of 726, 399 (55%) were perimembranous, 218 (30%) muscular, and 109 (15%) outlet VSD. VSD was small in 309 (42%), moderate in 337 (46%), and large in 80 (11%). Of 726 patients, 189 (26%) had congestive heart failure (CHF) and 52 (7.2%) developed pulmonary hypertension (PHT). Interestingly, one-third of CHF and PHT resolved over time during follow-up. Only 1 (0.1%) patient had infective endocarditis, 38 (5.2%) developed aortic regurgitation, and none had Eisenmenger syndrome. Overall, 149 (20%) needed surgery, 399 (55%) spontaneously closed, and 178 (25%) remained small. The mortality rate was 3.9% (28), 16 (57%) preoperatively, and 11 (39%) due to pneumonia. Trisomy 21, PHT, and birth weight <2.5 kg were independent factors for mortality with an adjusted hazard ratio of 6.0 (95% confidence interval [CI]: 2.1-16.9), 3.2 (95% CI: 1.2-8.4), and 3.6 (95% CI: 1.7-7.8), respectively. The overall survival at 1, 5, and 10 years was 96% (95% CI: 95-98), 95% (95% CI: 94-97), and 95% (95% CI: 94-97), respectively.

Conclusions: Despite limited pediatric and congenital cardiac services in middle-income countries, the overall survival of neonatal VSD is good, with poor outcomes in small infants, PHT, and trisomy 21.

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来源期刊
Annals of Pediatric Cardiology
Annals of Pediatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
14.30%
发文量
51
审稿时长
23 weeks
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