Abstract 19043: Global Surgical Outcomes for Congenital Heart Disease: A Look at Databases

Abstract

Introduction: Congenital heart diseases (CHDs) are the most common congenital anomalies, and almost one-third of patients require an intervention in the neonatal period or first year of life. Unlike low- and middle-income countries (LMICs), the survival of patients with CHD in high income countries is over 90%. The aim of this study was to compare the different congenital heart surgery (CHS) outcomes databases and analyze geographical variations. Methods: We analyzed the STS-CHSD (North America), the ECHSA, the ECHSA (Only Europe), and the IQIC for CHD (LMICs) databases between 2016 and 2019. All databases include aggregated data consisting of the 10-benchmark CHS and CHS grouped by mortality risk categories. For each database and condition, we extracted the number of participants, number of operations, postoperative length of stay (LOS), and mortality, comparing regional findings. Results: Compared to ECHSA, STS-CHSD database had more operations (32066 vs 14327) despite lower participant numbers. 50% of surgeries in LMIC were VSD closure, while the STS database reported the largest number of complex interventions. Mortality was lowest in North America for all the operations. LMICs had the shortest LOS, while North America had the longest LOS for almost all the benchmark operations. (Figure) However, the relevance of LOS is limited due to lack of data on demographic findings like age at surgery and gestation. Conclusions: The analysis of these three databases, accounting for limitations of aggregate data, highlight the differences in the CHS outcomes among world regions, reflecting the geographical difference of the population. Furthermore, it emphasizes the critical need to develop collaborative databases to improve global outcomes.