DETERMINANTS OF CARDIAC SURGERY OUTCOMES AMONG CHILDREN WHO UNDERWENT CARDIAC SURGERY AT CARDIAC CENTERS, ADDIS ABABA ETHIOPIA.

Abstract

ABSTRACT Background: Cardiac surgery causes high risk for the development of post-operative complications involving cardiovascular and respiratory system, as well as kidneys and central nervous system. Limitations in human resources and facilities for cardiac surgery and postoperative management in low-to-middle-income countries may have a negative impact on children cardiac surgery outcomes. This specific research is the first study in Ethiopia, will aid in understanding the factors that influence cardiac surgical outcomes at Addis Ababa’s cardiac centers. ii Objective: To assess the determinants of cardiac surgery outcomes among children who underwent cardiac surgery at Cardiac centers, Addis Ababa, Ethiopia, from May 2019-October 2022. Method: Institutional based retrospective cross-sectional study design was conducted. Simple random sampling technique was used to select medical records. The collected data was coded and entered into Epi data version 3.1 then exported to SPSS version 25 for descriptive and inferential statistical analysis. Binary logistic regression was done to see significant relation of independent and dependent variables. Adjusted odds ratio at 95% confidence level was estimated to assess the strength of the association and a p value of <0.05 was considered to declare the statistical significance in the logistic regression multivariable analysis. Result: In this study 413 patients were analyzed which make 97.6% chart completeness. From this 17.4% of them developed poor cardiac outcome. In multivariable logistic regression being Female (AOR: 1.456, CI: (1.12, 2.49)), Age > 5 years (AOR: 0.751, CI: (0.21, 0.91)), cardiac arrest (AOR: 2.06, CI: (1.21, 5.34)), blood loss (AOR: 0.59: CI: (0.12, 0.95)), were significantly associated with poor cardiac surgery outcome. Conclusion and Recommendation: the magnitude of poor cardiac surgery outcome in this study comparable to a study conducted in Ethiopia. In this study post-operative complication accounts for less morbidity and mortality. Due focus should be given on factors associated with poor cardiac outcome. A careful monitoring and follow-up of patients developed complication like blood loss, cardiac arrest during intra operation since they had high risk of developing poor outcome. Key words: Pediatrics cardiac surgery; outcome; Determinants; Addis Ababa Ethiopia.