title: The RACHS-1 risk category can be a predictor of perioperative recovery in Asian pediatric cardiac surgery patients.
abstract: OBJECTIVE
  The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification was originally designed to facilitate the prediction of in-hospital mortality for pediatric cardiac surgery patients. However, there have been few reports on clinical outcomes predicted by the RACHS-1 category, especially in an Asian population. The aim of this study was to determine whether RACHS-1 classification can predict patient outcomes.
  
  
  METHODS
  A total of 580 pediatric cardiac surgery procedures performed from January 2005 to December 2009 were retrospectively classified into the six RACHS-1 categories. The association between RACHS-1 category and clinical outcomes, including length of catecholamine requirement, mechanical ventilation time, intensive care unit stay, and in-hospital mortality, were examined.
  
  
  RESULTS
  The frequencies of RACHS-1 categories in the study population were: category 1, 10.7 %; category 2, 36.7 %; category 3, 42.8 %; category 4, 6.6 %; category 5, 0.0 %; category 6, 3.3 %. There was a significant linear correlation between RACHS-1 category and in-hospital mortality (r = 0.96, p < 0.001). Kaplan-Meier analysis demonstrated that length of catecholamine infusion, mechanical ventilation time, and ICU stay were significantly different (p < 0.05) in the different RACHS-1 categories, except for those between category 4 and 6 (p = 0.09).
  
  
  CONCLUSIONS
  Based on the results of our analysis, we conclude that the RACHS-1 stratification system can predict in-hospital mortality and patient outcomes in patients undergoing pediatric cardiac surgery.
authors.affiliation: Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, Kajiicho 465, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shibasaki
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Shime
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Toshiki
authors.initials: T
authors.lastname: Mizobe
authors.forename: Teiji
authors.initials: T
authors.lastname: Sawa
mesh_terms: D000293:Adolescent; D044466:Asian People; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020379:Risk Adjustment / Q000379:methods; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors