Risk factors for mortality in children with cyanotic congenital heart disease associated with brain abscess

Fauziah Pratiwi; Prastiya Indra Gunawan; Mahrus A. Rahman; Riza Noviandi; Sunny Mariana Samosir

doi:10.53730/ijhs.v6nS6.12599

Authors

Fauziah Pratiwi Department of Child Health, Faculty of Medicine Universitas Airlangga / Dr. Soetomo Hospital, Surabaya, Indonesia
Prastiya Indra Gunawan
prastiya-i-g@fk.unair.ac.id
Department of Child Health, Faculty of Medicine Universitas Airlangga / Dr. Soetomo Hospital, Surabaya, Indonesia
Mahrus A. Rahman Department of Child Health, Faculty of Medicine Universitas Airlangga / Dr. Soetomo Hospital, Surabaya, Indonesia
Riza Noviandi Department of Child Health, Faculty of Medicine Universitas Airlangga / Dr. Soetomo Hospital, Surabaya, Indonesia
Sunny Mariana Samosir Department of Child Health, Faculty of Medicine Universitas Airlangga / Dr. Soetomo Hospital, Surabaya, Indonesia

Keywords:

brain abscess, children, cyanotic congenital heart disease, mortality, risk factors

Abstract

Brain abscess is a local infection within the brain parenchyma. Predisposing factors include cyanotic congenital heart disease (CHD). Identification of risk factors for mortality is important to determine the prognosis. A case-control study of children with cyanotic CHD associated with brain abscess was conducted in the pediatric ward of a hospital from January 2016 to December 2020. Data were collected from medical records with the case to controls ratio of 1:3.07. A total of 61 children were evaluated, 46 children survived and 15 children non-survived. From 11 risk factors evaluated, 6 risk factors had a significant different of mortality risk included the level of hemoglobin (p=0.07), leukocyte (p=0.063), Neutrophil-to-lymphocyte ratio (NLR) (p<0.001), peripheral oxygen saturation (SpO₂) (p=0.00), multiple abscesses (p=0.008), brain abscess diameter (p<0.001). Multivariate logistic regression analyses revealed significant risk factors for mortality in cyanotic CHD children with brain abscesses were NLR (OR 13.62, 95%CI 2.123-87.319, p=0.006); SpO₂ (OR 1.5, 95% CI 1.25-2, p=0.04); brain abscess diameter (OR 7.61, 95%CI 1.064-54.434, p=0.043). NLR, brain abscess diameter, and SpO₂ were the risk factors in increasing mortality in cyanotic CHD children with brain abscess. The prevention of abscess cerebral development and cyanotic CHD management are needed to reduce the mortality.

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