title: Outcome of infants with unrepaired heart disease admitted to the pediatric intensive care unit: single-center developing country perspective.
abstract: OBJECTIVE
  Congenital heart disease (CHD) has an incidence of ∼0.8-1%. Outcome of previously diagnosed CHD patients awaiting surgery (either correction or palliation) in a developing country setting is unknown. We strive to determine the outcome of patients with CHD awaiting surgery who present to pediatric intensive care unit (PICU) setting with an acute illness.
  
  
  METHODS
  Retrospective cross-sectional chart review.
  
  
  METHODS
  Pediatric intensive care unit of The Aga Khan University Hospital, Karachi, Pakistan.
  
  
  METHODS
  Medical records of infants (1-12 months) with CHD awaiting surgery presenting to the PICU with an acute illness between January 2009 and June 2012 were included. Newly diagnosed CHD patients, those not requiring PICU admission, and those transferred to another hospital were excluded.
  
  
  RESULTS
  A total of 34 infants met the inclusion criteria. Median age at presentation was 5 months. Seventy-four percent of the infants had CHD lesion characterized by increased pulmonary blood flow (shunt lesions). Though none of the patients met the strict criteria for sepsis or pneumonia, 74% were admitted with a diagnosis of pneumonia or sepsis. Only 15% of patient had congestive heart failure as an admitting diagnosis. Oxygen therapy was given to 94% of these patients. Fifty-nine percent of these patients expired during the admission, 95% of those expired had multiorgan dysfunction.
  
  
  CONCLUSIONS
  Patients with CHD awaiting surgery and who admitted to the PICU with acute illness are at high risk for mortality. Stringent criteria to diagnose pneumonia or sepsis should be used in these patients.
authors: Department of Pediatric and Child Health, The Aga Khan University, Karachi, Pakistan.
authors: Shazia Samad
authors: SS
authors: Mohsin
authors: Anwarul
authors: A
authors: Haque
authors: Abdul Sattar
authors: AS
authors: Shaikh
authors: Surraiya
authors: S
authors: Bano
authors: Babar Sultan
authors: BS
authors: Hasan
mesh_terms: D000367:Age Factors; D006348:Cardiac Surgical Procedures; D003430:Cross-Sectional Studies; D003906:Developing Countries; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D015278:Intensive Care Units, Pediatric; D010154:Pakistan; D010343:Patient Admission; D011014:Pneumonia / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D014850:Waiting Lists
keywords: Infants; Mortality; Unrepaired Congenital Heart Disease