title: Risk stratification and outcome of cardiac surgery for patients with body weight <2 ,500g in an Asian center.
abstract: BACKGROUND
  Cardiac surgery performed in patients with low body weight is a challenge for surgeons. Currently, such outcomes are mainly reported from European or North American centers. In this study, we review our cardiac surgery experience with neonates and infants weighing <2,500g.
  
  
  RESULTS
  We included patients with a body weight <2,500g who received cardiac surgery between January 2008 and December 2012. The survival outcome was compared to that of patients with large body weight, and then the Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1) categorization was used for operative risk stratification. In the 1,245 index operations, 53 patients (4.3%) were <2,500g. The mean body weight was 2,232g (range 1,320-2,500g). The hospital mortality rate was 20.7% (11/53). Most (85%) of the procedures were in RACHS-1 category ≥3. The risk ratio was significantly higher in RACHS-1 category 3 (relative risk [RR]:6.2; 95% confidence interval [CI]:1.6-23.9) and 4 (RR:4.6; 95% CI:1.4-15.0), respectively, while it was not significantly different in category 2 (RR:1.02; 95% CI:1.01-1.02) and category 6 (RR:2.9; 95% CI:0.36-13.3).
  
  
  CONCLUSIONS
  Cardiac surgery performed on infants with low body weight is generally a complex procedure, but the results are acceptable. The risk was higher than that for patients with higher body weight in RACHS-1 category 3 and 4. Further investigation to improve the outcome of this high-risk group is needed.
authors.affiliation: Departments of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine.
authors.forename: Jeng-Wei
authors.initials: JW
authors.lastname: Chen
authors.forename: Yih-Sharng
authors.initials: YS
authors.lastname: Chen
authors.forename: Chung-I
authors.initials: CI
authors.lastname: Chang
authors.forename: Ing-Sh
authors.initials: IS
authors.lastname: Chiu
authors.forename: Nai-Kuan
authors.initials: NK
authors.lastname: Chou
authors.forename: Hsing-Hao
authors.initials: HH
authors.lastname: Huang
authors.forename: Chi-Hsiang
authors.initials: CH
authors.lastname: Huang
authors.forename: Shu-Chien
authors.initials: SC
authors.lastname: Huang
mesh_terms: D044466:Asian People; D001724:Birth Weight; D006348:Cardiac Surgical Procedures; D018572:Disease-Free Survival; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology