Preoperative percutaneous oxygen saturation is a predictor of
postoperative adverse events after Ebstein's anomaly reconstruction
Abstract
Background Ebstein’s anomaly (EA) is a kind of congenital heart disease,
which is currently widely treated by cone reconstruction. However,
prediction of postoperative recovery is still challenging. Methods A
retrospective analysis was performed on EA cases undergoing cone
reconstruction from January 2010 to January 2016. Univariate and
multivariate logistic regression analyses were performed, with
postoperative adverse events defined as dependent variable and pre- and
intra-operative parameters defined as independent variables. Predictive
capacity of preoperative SPO2 and Great Ormond Street (GOS) score was
evaluated using areas under the curve of receiver operating
characteristic (ROC). Results Preoperative SPO2 was 95.7 ± 5.20%.
Cardiopulmonary bypass, aortic cross-clamp, postoperative mechanical
ventilation, and hospitalization time were 101.7 ± 28.26 min, 60.9 ±
18.04 min, 16 hours (8, 22), and 8 days (7, 11), respectively. The
incidence of total postoperative adverse events including low cardiac
output syndrome, mechanical ventilation more than 3 days, postoperative
hospitalization more than 2 weeks, postoperative re-intubation,
extracorporeal membrane oxygenation assistance, and death was 13.1%
(n=13). Low pre-operative SPO2 (P=0.001, OR=0.834), GOS score (P=0.021,
OR=0.368), and cardiopulmonary bypass time (P=0.034, OR=1.021) were risk
factors for adverse events. Multivariate logistic regression analysis
showed that low preoperative SPO2 (P=0.002, OR=0.846) and GOS score
(P=0.043, OR=0.577) were independent risk factors for adverse events.
The areas of SPO2 and GOS score under the ROC curve were 0.764 and
0.740, respectively. Conclusions Low pre-operative SPO2 and GOS score
were predictors of adverse events after cone reconstruction, and SPO2
was more convenient and objective than GOS score.