title: Analysis of Surgical Mortality for Congenital Heart Defects Using RACHS-1 Risk Score in a Brazilian Single Center.
abstract: Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease.
  
  
  
  To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period.
  
  
  
  A retrospective date analysis was performed from January 2003 to December 2014. The survey was divided in two periods of six years long each, to check for any improvement in the results. We evaluated the numbers of procedures performed, complexity of surgery and hospital mortality.
  
  
  
  Three thousand and two hundred and one surgeries were performed. Of these, 3071 were able to be classified according to the score RACHS-1. Among the patients, 51.7% were male and 47.5% were younger than one year of age. The most common RACHS-1 category was 3 (35.5%). The mortality was 1.8%, 5.5%, 14.9%, 32.5% and 68.6% for category 1, 2, 3, 4 and 6, respectively. There was a significant increase in the number of surgeries (48%) and a significant reduction in the mortality in the last period analysed (13.3% in period I and 10.4% in period II; P=0.014).
  
  
  
  RACHS-1 score was a useful score for mortality risk in our service, although we are aware that other factors have an impact on the total mortality.
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Candice Torres de Melo Bezerra
authors.initials: CT
authors.lastname: Cavalcante
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Nayana Maria Gomes
authors.initials: NMG
authors.lastname: de Souza
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Valdester Cavalcante
authors.initials: VC
authors.lastname: Pinto
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Klébia Magalhães Pereira Castello
authors.initials: KM
authors.lastname: Branco
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Ronald Guedes
authors.initials: RG
authors.lastname: Pompeu
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Andreia Consuelo de Oliveira
authors.initials: AC
authors.lastname: Teles
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Rodrigo Cardoso
authors.initials: RC
authors.lastname: Cavalcante
authors.affiliation: Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, CE, Brazil.
authors.forename: Giselle Viana
authors.initials: GV
authors.lastname: de Andrade
mesh_terms: D000293:Adolescent; D001938:Brazil; D006348:Cardiac Surgical Procedures / Q000401:mortality* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D020379:Risk Adjustment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers / Q000706:statistics & numerical data