■关于中等收入国家室间隔缺损(VSD)的生存和预后的数据有限。因此,本研究旨在确定新生儿VSD的生存率和与死亡率相关的因素.
■这是一个回顾,2009年至2019年间出生的孤立性VSD新生儿的基于人群的研究。使用Kaplan-Meier分析来估计总生存期。Cox回归分析用于确定与死亡率相关的因素。
■研究了726名患者,其中82人(11%)患有21三体。诊断和随访的中位年龄为5天(四分位距[IQR]:2-10天)和2.3岁(IQR:0.6-4.8岁),分别。726,399(55%)是膜周,218(30%)肌肉,和109(15%)出口VSD。309例(42%)的室间隔缺损较小,337(46%)中等,和80(11%)大。726名患者中,189(26%)患有充血性心力衰竭(CHF),52(7.2%)患有肺动脉高压(PHT)。有趣的是,在随访期间,随着时间的推移,三分之一的CHF和PHT得以解决。只有1例(0.1%)患者有感染性心内膜炎,38(5.2%)发生主动脉瓣反流,没有人患有艾森曼格综合征.总的来说,149(20%)需要手术,399(55%)自发关闭,和178(25%)仍然很小。死亡率为3.9%(28),16人(57%)术前,和11(39%)由于肺炎。21三体,PHT,出生体重<2.5kg是死亡率的独立因素,调整后的风险比为6.0(95%置信区间[CI]:2.1-16.9),3.2(95%CI:1.2-8.4),和3.6(95%CI:1.7-7.8),分别。1年,5年和10年的总生存率为96%(95%CI:95-98),95%(95%CI:94-97),和95%(95%CI:94-97),分别。
■尽管中等收入国家的儿科和先天性心脏服务有限,新生儿VSD的总体生存率良好,小婴儿的不良结局,PHT,和21三体。
UNASSIGNED: Limited data on the survival and outcomes of ventricular septal defect (VSD) in middle-income countries are available. Hence, this
study aims to determine the survival and factors associated with mortality among neonatal VSD.
UNASSIGNED: This is a retrospective, population based
study of neonates with isolated VSD born between 2009 and 2019. Kaplan-Meier analysis was used to estimate the overall survival. Cox regression analysis was used to determine factors associated with mortality.
UNASSIGNED: There were 726 patients studied, with 82 (11%) of them having trisomy 21. The median age of diagnosis and follow-up was 5 days (interquartile range [IQR]: 2-10 days) and 2.3 years (IQR: 0.6-4.8 years), respectively. Of 726, 399 (55%) were perimembranous, 218 (30%) muscular, and 109 (15%) outlet VSD. VSD was small in 309 (42%), moderate in 337 (46%), and large in 80 (11%). Of 726 patients, 189 (26%) had congestive heart failure (CHF) and 52 (7.2%) developed pulmonary hypertension (PHT). Interestingly, one-third of CHF and PHT resolved over time during follow-up. Only 1 (0.1%) patient had infective endocarditis, 38 (5.2%) developed aortic regurgitation, and none had Eisenmenger syndrome. Overall, 149 (20%) needed surgery, 399 (55%) spontaneously closed, and 178 (25%) remained small. The mortality rate was 3.9% (28), 16 (57%) preoperatively, and 11 (39%) due to pneumonia. Trisomy 21, PHT, and birth weight <2.5 kg were independent factors for mortality with an adjusted hazard ratio of 6.0 (95% confidence interval [CI]: 2.1-16.9), 3.2 (95% CI: 1.2-8.4), and 3.6 (95% CI: 1.7-7.8), respectively. The overall survival at 1, 5, and 10 years was 96% (95% CI: 95-98), 95% (95% CI: 94-97), and 95% (95% CI: 94-97), respectively.
UNASSIGNED: Despite limited pediatric and congenital cardiac services in middle-income countries, the overall survival of neonatal VSD is good, with poor outcomes in small infants, PHT, and trisomy 21.