Influential factors in mortality rate from congenital heart disease. Studyon 1,216 children in the autonomous community of Murcia, Spain (1978-1990)

Introduction. In the last few years, important progress has taken place in management of congenital heart disease. These changes have had an influence on diagnosis, preoperative management, surgery treatment and postoperative care, giving rise to better results in the treatment of children suffering from congenital heart disease. Aim. To assess the results of congenital heart diseases in a reference hosp ital by comparing two periods with reference to both diagnosis and therapeu tical management. We also intend to investigate the influence that factors such as the existence of extracardiac congenital malformations and heart su rgery have on mortality. Patients and methods. Our sample group was made up of 1,216 children suffer ing from congenital heart disease. Their ages ranged from 1 day to 7 years old. These children were born over a period of thirteen years and studied a t the paediatric cardiology unit in a reference hospital in the Autonomous Community of Murcia, a region of Spain. We retrospectively analysed their d evelopment by individual heart diseases land their associated factors), and the global results. Our research was divided into two periods: between 1978 and 1983, and betwe en 1984 and 1990. Differences were found regarding diagnosis and treatment. Results. a) Mortality rate from congenital heart disease decreased in the p eriod between 1984 and 1990 in comparison to the period between 1978 and 19 83, from 28 to 21,7% (p < 0.05); b) individually, the mortality rate decrea sed with statistical significance in two diseases: interventricular communi cation and patent ductus arteriosus, and c) there is a higher mortality rat e of patients with no surgery treatment and/or extracardiac malformations. Conclusion. Progress in the management of congenital heart disease has led to a more favourable outcome in the last years.