Weight-for-age standard score distribution and effect on in-hospital mortality: A retrospective analysis in pediatric cardiac surgery.
Ann Card Anaesth
;
2015 Jul; 18(3): 367-372
Article
in English
| IMSEAR
| ID: sea-162337
ABSTRACT
Objective:
To study the distribution of weight for age standard score (Z score) in pediatric cardiac surgery and its effect on in-hospital mortality.Introduction:
WHO recommends Standard Score (Z score) to quantify and describe anthropometric data. The distribution of weight for age Z score and its effect on mortality in congenital heart surgery has not been studied.Methods:
All patients of younger than 5 years who underwent cardiac surgery from July 2007 to June 2013, under single surgical unit at our institute were enrolled. Z score for weight for age was calculated. Patients were classified according to Z score and mortality across the classes was compared. Discrimination and calibration of the for Z score model was assessed. Improvement in predictability of mortality after addition of Z score to Aristotle Comprehensive Complexity (ACC) score was analyzed.Results:
The median Z score was -3.2 (Interquartile range -4.24 to -1.91] with weight (mean±SD) of 8.4 ± 3.38 kg. Overall mortality was 11.5%. 71% and 52.59% of patients had Z score < -2 and < -3 respectively. Lower Z score classes were associated with progressively increasing mortality. Z score as continuous variable was associated with O.R. of 0.622 (95% CI- 0.527 to 0.733, P < 0.0001) for in-hospital mortality and remained significant predictor even after adjusting for age, gender, bypass duration and ACC score. Addition of Z score to ACC score improved its predictability for in-hosptial mortality (δC - 0.0661 [95% CI - 0.017 to 0.0595, P = 0.0169], IDI- 3.83% [95% CI - 0.017 to 0.0595, P = 0.00042]).Conclusion:
Z scores were lower in our cohort and were associated with in-hospital mortality. Addition of Z score to ACC score significantly improves predictive ability for in-hospital mortality.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Severity of Illness Index
/
Body Weight
/
Humans
/
Infant, Newborn
/
Child
/
Child, Preschool
/
Survival Rate
/
Retrospective Studies
/
Cohort Studies
/
Hospital Mortality
Type of study:
Etiology study
/
Incidence study
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Observational study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Ann Card Anaesth
Year:
2015
Type:
Article
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