Evidence map›Paper›PMID 39736735›Full record

ArticleJournal of cardiothoracic surgery2024

Short term outcomes of the first pediatric cardiac surgery program in Rwanda.

Yayehyirad Ejigu, Vongai C Mlambo, Kara L Neil, Habtamu Sime, Rex Wong, Michel R Gatera, Gaston Nyirigira, Yilkal C Sewnet, Yihan Lin, Bertrand Byishimo and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiothoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Yayehyirad EjiguKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda. hakimyayu@gmail.com.
Vongai C MlamboStanford University School of Medicine, Stanford, CA, USA.
Kara L NeilKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda.
Habtamu SimeKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda.
Rex WongUniversity of Global Health Equity, Butaro, Rwanda.
Michel R GateraKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda.
Gaston NyirigiraKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda.
Yilkal C SewnetKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda.
Yihan LinDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Bertrand ByishimoKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda.
Gloria RukomezaKing Faisal Hospital Rwanda, #66 KG 5 Avenue, Kacyiru, Kigali, Rwanda.
Yves MutabandamaUniversity Teaching Hospital of Kigali, Kigali, Rwanda.
Emmanuel RusingizaUniversity Teaching Hospital of Kigali, Kigali, Rwanda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile the number of cardiac surgery programs in sub-Saharan Africa are increasing, it is still insufficient. With only 0.08 pediatric cardiac surgeons per million people, few cardiac centers routinely perform pediatric cardiac surgery. This has led to reliance on humanitarian medical missions or referral abroad for most African nations. This study outlines the outcomes of Rwanda's first sustainable pediatric cardiac surgery program.

methodsA retrospective chart review was performed for all pediatric patients who received cardiac surgery between October 2022 and April 2024. Patient demographics, procedures, operative times, length of stay, complications, and 30-day mortality were synthesized. Perioperative factors associated with complications and prolonged intensive care unit length of stay were evaluated using logistic and linear regression analysis, respectively.

results207 patients received 240 cardiac procedures. At time of surgery, 45% of patients were 1-5 years old (n = 95). The top five procedures were repair of Ventricular Septal Defect, Patent Ductus Arteriosus, Atrial Septal Defect, Tetralogy of Fallot and Coarctation of the Aorta. 30-day mortality was 1.9% (n = 4) and 6.3% (n = 13) experienced a major complication. Additionally, 24% (n = 50) experienced minor complications, most commonly, pneumonia. The linear combination of surgery duration, cross clamp and bypass time was significantly associated with having complications (aOR = 0.67, p = 0.01). Younger age, longer operative times, number of inotropes and the presence of complications were associated with an increased intensive care unit stay.

conclusionsThe 30-day surgical outcomes are favorable compared to programs with a similar case mix, showing that pediatric cardiac surgery can be safely performed in developing countries with local cardiac teams. Prolonged bypass and cross clamp times were associated with higher complication rates and increased inotrope use was associated with longer intensive care unit stay.

Indexed as

Cardiac Surgical ProceduresHeart Defects, CongenitalAdolescentChildChild, PreschoolFemaleHumansInfantInfant, NewbornLength of StayMaleOperative TimePostoperative ComplicationsRetrospective StudiesRwandaTreatment OutcomeCardiac surgeryCongenitalOutcomesSub-Saharan Africa

Identifiers

PMID39736735
PMCPMC11686828

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.