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The RACHS-1 risk category can be a predictor of perioperative recovery in Asian pediatric cardiac surgery patients

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Abstract

Purpose

The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification was originally designed to facilitate the prediction of in-hospital mortality for pediatric cardiac surgery patients. However, there have been few reports on clinical outcomes predicted by the RACHS-1 category, especially in an Asian population. The aim of this study was to determine whether RACHS-1 classification can predict patient outcomes.

Methods

A total of 580 pediatric cardiac surgery procedures performed from January 2005 to December 2009 were retrospectively classified into the six RACHS-1 categories. The association between RACHS-1 category and clinical outcomes, including length of catecholamine requirement, mechanical ventilation time, intensive care unit stay, and in-hospital mortality, were examined.

Results

The frequencies of RACHS-1 categories in the study population were: category 1, 10.7 %; category 2, 36.7 %; category 3, 42.8 %; category 4, 6.6 %; category 5, 0.0 %; category 6, 3.3 %. There was a significant linear correlation between RACHS-1 category and in-hospital mortality (r = 0.96, p < 0.001). Kaplan–Meier analysis demonstrated that length of catecholamine infusion, mechanical ventilation time, and ICU stay were significantly different (p < 0.05) in the different RACHS-1 categories, except for those between category 4 and 6 (p = 0.09).

Conclusions

Based on the results of our analysis, we conclude that the RACHS-1 stratification system can predict in-hospital mortality and patient outcomes in patients undergoing pediatric cardiac surgery.

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Conflict of interest

No conflicts of interest declared.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, Kajiicho 465, Kamigyo-ku, Kyoto, 602-8566, Japan

    Yoshinobu Nakayama, Masayuki Shibasaki, Yasufumi Nakajima, Toshiki Mizobe & Teiji Sawa

  2. Trauma and Critical Care Center, Emergency Intensive Care Unit, Kyoto Medical Center, Kyoto, Japan

    Nobuaki Shime

Authors
  1. Yoshinobu Nakayama
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  2. Masayuki Shibasaki
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  3. Nobuaki Shime
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  4. Yasufumi Nakajima
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  5. Toshiki Mizobe
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  6. Teiji Sawa
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Corresponding author

Correspondence to Masayuki Shibasaki.

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Nakayama, Y., Shibasaki, M., Shime, N. et al. The RACHS-1 risk category can be a predictor of perioperative recovery in Asian pediatric cardiac surgery patients. J Anesth 27, 850–854 (2013). https://doi.org/10.1007/s00540-013-1645-1

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  • DOI: https://doi.org/10.1007/s00540-013-1645-1

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