Analysis on the Risk Factors of Postoperative Hyperbilirubinemia in Children with Congenital Heart Disease
Objective To analyze the risk factors and impact on prognosis of hyperbilirubinemia after congenital heart disease surgery in children.Methods The medical record data of 5 828 children with congenital heart disease surgery in the Department of Cardiac Surgery of our center from July 2015 to February 2023 were retrospectively analyzed.According to the maximum value of serum total bilirubin(TBIL)level at 7 d after surgery,all cases were divided into hyperbilirubinemia group(TBIL>51 μmol/L,882 cases)and control group(TBIL≤51 μmol/L,4946 cases).The perioperative related indicators were compared between the two groups,and univariate and multivariate Logistic regression models were used to analyze the independent risk factors for postoperative hyperbilirubinemia in children with congenital heart disease.Results The incidence of postoperative hyperbilirubinemia in children with congenital heart disease was 15.1%.Multivariate Logistic regression analysis showed that preoperative TBIL>17 μmol/L(OR=12.986,P=0.005)and DBIL>7 μmol/L(OR=8.107,P=0.015)were independent risk factors for postoperative hyperbilirubinemia in children with congenital heart disease.The comparison of postoperative mortality rate,incidence of postoperative acute kidney injury,mechanical ventilation time,ICU stay time,hospitalization time,and hospitalization cost between the two groups showed statistically significant differences(P<0.05).Conclusions Preoperative TBIL>17 μmol/L and DBIL>7 μmol/L are independent risk factors for postoperative hyperbilirubinemia in children with congenital heart disease.Postoperative hyperbilirubinemia is significantly associated with increased postoperative mortality and incidence of postoperative acute kidney injury,prolonged ICU stay time,mechanical ventilation time and hospitalization time,and increased hospitalization cost.
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