Predictors of mortality and morbidity in acyanotic congenital heart disease with pulmonary hypertension: A cross-sectional study of patients at Dr. Soetomo General Academic Hospital Surabaya
Main Article Content
Keywords
Acyanotic congenital heart disease, Malnutrition, Mortality, nutritional status, pulmonary hypertension, surgical outcome
Abstract
Introduction: Congenital heart defects (CHDs) are the most common major congenital malformations in neonates. Pulmonary hypertension frequently develops as a complication, particularly in chronic or uncorrected defects. The interaction between anatomical abnormalities, hemodynamic alterations, nutritional status, and surgical outcomes highlights the need for a multidisciplinary approach to management. This study aimed to evaluate the clinical characteristics, pulmonary hypertension severity, nutritional status, and outcomes of patients with acyanotic congenital heart disease complicated by pulmonary hypertension.
Methods: A cross-sectional study was conducted from August 2024 to August 2025, utilizing secondary data obtained from electronic medical records. Acyanotic congenital heart disease diagnosis, pulmonary hypertension severity, nutritional status, cardio-pulmonary bypass duration, aorta clamping duration, duration of stay, and mortality were noted.
Results: Out of 80 recorded cases of acyanotic congenital heart disease, 37 patients with complete records were identified to have accompanying pulmonary hypertension. The mean age was 13.2 ± 14.3 years, with the majority aged 1–5 years (40.5%), and females comprising 71.3% of the study. Malnutrition was highly prevalent, with a mean Body Mass Index (BMI) of 14.9 ± 4.8 kg/m²; 83.8% were underweight. Ventricular septal defect (64.9%) was the most common lesion, followed by atrial septal defect (45.9%) and atrioventricular septal defect (18.9%). Severe pulmonary hypertension was observed in 56.8% of patients, most frequently observed with ventricular septal defects (VSD). Valvular abnormalities were also common, notably tricuspid regurgitation (40.5%) and mitral regurgitation (27%). The overall mortality rate was 21.6%, occurring exclusively in underweight patients, suggesting a strong link between poor nutritional status and adverse outcomes.
Conclusion: Severe pulmonary hypertension and malnutrition were observed with adverse outcomes, underscoring the need for early intervention and nutritional optimization in acyanotic congenital heart disease.
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