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A population-based study relevant to seasonal variations in causes of death in children undergoing surgery for congenital cardiac malformations

Published online by Cambridge University Press:  22 June 2007

Leif T. Eskedal ,
Petter S. Hagemo ,
Anne Eskild ,
Kathrine F. Frøslie ,
Stephen Seiler  and
Erik Thaulow
Leif T. Eskedal*
Affiliation:
Department of Paediatrics, Sørlandet Regional Hospital, Kristiansand, Norway
Petter S. Hagemo
Affiliation:
Section Paediatric Cardiology, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway
Anne Eskild
Affiliation:
Department of Obstetrics and Gynaecology, Akershus University Hospital, and Division of Mental Health, National Institute of Public Health, Oslo, Norway
Kathrine F. Frøslie
Affiliation:
Section of Biostatistics, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway
Stephen Seiler
Affiliation:
Faculty of Health and Sport, Agder University College, Kristiansand, Norway
Erik Thaulow
Affiliation:
Section Paediatric Cardiology, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway
*
Correspondence to: L Eskedal, Department of Paediatrics, SSHF, service box 416, 4604 Kristiansand, Norway. Tel: +47 3807 4010; Fax: +47 3807 4041; E-mail: [email protected]
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Abstract

Aims

Our objectives were, first, to study seasonal distribution of perioperative deaths within 30 days after surgery, and late death, in children undergoing surgery for congenitally malformed hearts, and second, to study the causes of late death.

Methods

We analysed a retrospective cohort of 1,753 children with congenital cardiac malformations born and undergoing surgery in the period from 1990 through 2002 with a special focus on the causes of late death. The data was obtained from the registry of congenital cardiac malformations at Rikshospitalet, Oslo, and the Norwegian Medical Birth Registry. The mean follow-up from birth was 8.1 years, with a range from zero to 15.2 years.

Results

During the period of follow-up, 204 (11.6%) of the children died having undergone previous surgery. Of these 124 (7.1%) died in the perioperative period, and 80 (4.5%) were late deaths. There were 56 late deaths during the 6 coldest months, compared with 24 during the 6 warmest months (p < 0.01). There was no significant seasonal variation in perioperative deaths. Respiratory infection was the most common cause of late death, and occurred in 25 children, of whom 24 died during the 6 coldest months. Of the 8 sudden late deaths, 7 occurred during the 6 coldest months. There was no seasonal variation for the other causes of death.

Conclusions

In children undergoing surgery for congenital cardiac malformations in Norway, there is a seasonal variation in late death, with a higher proportion occurring in the coldest months. Death related to respiratory infections predominantly occurs in the winter season, and is the overall most common cause of late death.

Keywords

Mortalityrespiratory infectionrespiratory syncytial virussudden deathDown's syndrome
Type
Original Article
Information
Cardiology in the Young , Volume 17 , Issue 4 , August 2007 , pp. 423 - 431
Copyright
Copyright © Cambridge University Press 2007

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