Abstract

GUERCHICOFF, Marianna et al. Evaluación del impacto del diagnóstico precoz de las cardiopatías congénitas. Arch. argent. pediatr. [online]. 2004, vol.102, n.6, pp.445-450. ISSN 0325-0075.

Introduction. Congenital heart diseases are the most frequent severe congenital defects and one of the three major causes of prenatal and perinatal mortality. Previous studies have shown that prenatal diagnosis of congenital heart diseases has a significant impact on the prognosis of these patients. The first aim of the present study was to assess the impact of early diagnosis of severe congenital heart diseases on global mortality, mortality previous to surgery and surgical mortality. Secondary aims of the study included the impact of early diagnosis of severe congenital heart diseases on the length of hospital stay and hospital costs. Population, material and methods. 86 newborns with severe congenital heart diseases. This was a retrospective cohort study. Patients were divided into two groups: I: patients born at our institution (49), II: patients referred from other centers (37). Variables studied were: early diagnosis of congenital heart diseases, mortality prior to intervention, surgical mortality, overall mortality, age at time of intervention, length of hospital stay and hospital costs. Results. All the newborns from group I had early diagnosis of severe congenital heart disease and received immediate treatment. In 7 infants of this group, prenatal diagnosis allowed the elective delivery in our hospital. 13% of group II newborns died before any therapeutic intervention could be performed. Surgical mortality was similar for both groups. There were no differences between the type and severity of the congenital heart diseases found in each group. Statistically significant differences were found when median age at intervention, median length of hospital stay and total hospital costs were compared. Conclusions. In our study, early diagnosis of severe congenital heart diseases allowed the affected newborns to receive timely treatment. 13% of the patients without early diagnosis died before any treatment could be carried out. When both groups were compared, patients without early diagnosis were operated on at a later age and the median length of hospital stay and final total costs were higher than those with early diagnosis.

Keywords : Severe congenital heart diseases; Early diagnosis; Mortality; Survival.

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