Risk factors for mortality in children with cyanotic congenital heart disease associated with brain abscess

Abstract

Brain abscess is a local infection within the brain parenchyma. Predisposing factors include cyanotic congenital heart disease (CHD). Identification of risk factors for mortality is important to determine the prognosis. A case-control study of children with cyanotic CHD associated with brain abscess was conducted in the pediatric ward of a hospital from January 2016 to December 2020. Data were collected from medical records with the case to controls ratio of 1:3.07. A total of 61 children were evaluated, 46 children survived and 15 children non-survived. From 11 risk factors evaluated, 6 risk factors had a significant different of mortality risk included the level of hemoglobin (p=0.07), leukocyte (p=0.063), Neutrophil-to-lymphocyte ratio (NLR) (p<0.001), peripheral oxygen saturation (SpO2) (p=0.00), multiple abscesses (p=0.008), brain abscess diameter (p<0.001). Multivariate logistic regression analyses revealed significant risk factors for mortality in cyanotic CHD children with brain abscesses were NLR (OR 13.62, 95%CI 2.123-87.319, p=0.006); SpO2 (OR 1.5, 95% CI 1.25-2, p=0.04); brain abscess diameter (OR 7.61, 95%CI 1.064-54.434, p=0.043). NLR, brain abscess diameter, and SpO2 were the risk factors in increasing mortality in cyanotic CHD children with brain abscess. The prevention of abscess cerebral development and cyanotic CHD management are needed to reduce the mortality.