Revista Brasileira de Cirurgia Cardiovascular
versión On-line ISSN 1678-9741
NINA, Rachel Vilela de Abreu Haickel et al. Is the RACHS-1 (risk adjustment in congenital heart surgery) a useful tool in our scenario?. Rev Bras Cir Cardiovasc [online]. 2007, vol.22, n.4, pp. 425-431. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76382007000400008.
OBJECTIVE: The aim of this study was to evaluate the applicability of the RACHS-1 (Risk Adjustment in Congenital Heart Surgery) as a predictor of surgical mortality in a pediatric population of a public hospital of the Northeast of Brazil. METHODS: From June 2001 through June 2004, 145 patients undergone surgical treatment of CHD in our institution of whom 62% were female, and the mean age was 5.1 years. The RACHS-1 was used to classify the surgical procedures into categories of risk 1 to 6, and logistic regression analysis was used to identify the risk factors related to surgical death. RESULTS: Age, type of CHD, pulmonary flow, surgical procedure, pump time and cross clamp time were identified as a risk factor for postoperative mortality (p<0.001). There was a linear correlation between the categories of the RACHS-1 and the mortality rate; however, the observed mortality was greater than the predicted figures by that scoring system. CONCLUSION: Although the RACHS-1 is easily applicable, it can not be applicable in our scenario because it takes into account only the surgical procedure as a categorized variable, not considering others factors presented in our scenario that could interfere in the final surgical result.
Palabras clave : Heart defects, congenital [surgery]; Mortality; Risk adjustment.