Is the RACHS-1 (risk adjustment in congenital heart surgery) a useful tool in our scenario?
OBJECTIVE
The aim of this study was to evaluate the applicability of the RACHS-1 (Risk Adjustment in Congenital Heart Surgery) as a predictor of surgical mortality in a pediatric population of a public hospital of the Northeast of Brazil.


METHODS
From June 2001 through June 2004, 145 patients undergone surgical treatment of CHD in our institution of whom 62% were female, and the mean age was 5.1 years. The RACHS-1 was used to classify the surgical procedures into categories of risk 1 to 6, and logistic regression analysis was used to identify the risk factors related to surgical death.


RESULTS
Age, type of CHD, pulmonary flow, surgical procedure, pump time and cross clamp time were identified as a risk factor for postoperative mortality (p<0.001). There was a linear correlation between the categories of the RACHS-1 and the mortality rate; however, the observed mortality was greater than the predicted figures by that scoring system.


CONCLUSIONS
Although the RACHS-1 is easily applicable, it can not be applicable in our scenario because it takes into account only the surgical procedure as a categorized variable, not considering others factors presented in our scenario that could interfere in the final surgical result.
Nina
Rachel Vilela de Abreu Haickel
RV
UFMA University Hospital. rachelnina@terra.com.br
Gama
Mônica Elinor Alves
ME
Santos
Alcione Miranda dos
AM
Nina
Vinícius José da Silva
VJ
Figueiredo Neto
José Albuquerque de
JA
Mendes
Vinícius Giuliano Gonçalves
VG
Lamy
Zeni Carvalho
ZC
Brito
Luciane Maria de Oliveira
LM
D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011184:Postoperative Period; D020379:Risk Adjustment / Q000379:methods / Q000592:standards*