Survival Status and It’s Associated Factors Among Under Five Children Managed with Congenital Heart Diseases in Tikur Anbessa Specialized Hospital and Cardiac Center, Addis Ababa, Ethiopia, 2022/2023: A Retrospective Cohort Study
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Date
2023
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Addis Ababa University
Abstract
Background: Congenital heart disease CHD is the most prevalent significant congenitalabnormality, affecting around 9 out of every 1000 live infants. The aggregated 1-year and 5-year survival rates for patients with congenital heart disease from 6 and 8 studies for all CHDwere 87.0% and 85.4%, respectively.
Objective: The purpose of this study is to assess survival status and related factors amongunder-five infants with congenital heart disorders treated at TASH, Addis Ababa, Ethiopia,and Cardiac Centre from January 2018 to December 2022.
Methods: An Institution based retrospective follow-up study design was used among under-five children managed with congenital heart disease that were admitted at TASH and CardiacCenter, Ethiopia; registered from Jan 2018 to Dec 2022. Data was collected by pretestedchecklist from 224 randomly selected charts. The Kaplan-Meier survival analysis, the log-ranktest, and the effect of each covariate on mortality using cox proportional hazard are used to measure survival status in various groups. For data analysis, SPSS version 26 was employed.
Result : Total of 224 charts with 95.32% response rate were analyzed to determine survival status and associated factors of under-five children managed with CHD and 34 of them died whereas 190 of them were censored during the study period. The survival status of all infants born with CHD in this study was 84.8% to five years. Cox regression analysis identifiedcovariates significantly associated with mortality as weight at admission (AHR 19.023,95% CI[2.542,142.925]; P = 0.004), types of interventions (AHR73.016,95% CI [3.226,1652.2]; P =0.007), pre-operative condition (AHR 65.097,95% CI [11.322,374.25]; P =0.0001), familyhistory of heart disease (AHR 10.81,95% CI [2.218,52.673]; P = 0.003), maternal history ofsubstance use (AHR 46.67,95% CI [4.405,494.31]; P = 0.001) and maternal history of viral infection (AHR 52.034,95% CI [7.320,369.83]; P< 0.0001).
Conclusion and recommendation: The survival status of all infants born with CHD in thisstudy was 84.8% to five years. Weight at type of interventions, preoperative condition, othermaternal condition are associated with survival. The early cardiac intervention and priority for critical CHD are among recommendation to improve survival.
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Keywords
Congenital heart disease, Survival status, associated factors, Cox regression, log rank, Kaplan Meier.