title: Is the RACHS-1 (risk adjustment in congenital heart surgery) a useful tool in our scenario?
abstract: 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.
authors.affiliation: UFMA University Hospital. rachelnina@terra.com.br
authors.forename: Rachel Vilela de Abreu Haickel
authors.initials: RV
authors.lastname: Nina
authors.forename: Mônica Elinor Alves
authors.initials: ME
authors.lastname: Gama
authors.forename: Alcione Miranda dos
authors.initials: AM
authors.lastname: Santos
authors.forename: Vinícius José da Silva
authors.initials: VJ
authors.lastname: Nina
authors.forename: José Albuquerque de
authors.initials: JA
authors.lastname: Figueiredo Neto
authors.forename: Vinícius Giuliano Gonçalves
authors.initials: VG
authors.lastname: Mendes
authors.forename: Zeni Carvalho
authors.initials: ZC
authors.lastname: Lamy
authors.forename: Luciane Maria de Oliveira
authors.initials: LM
authors.lastname: Brito
mesh_terms: 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*