PEACH Score Validation as a Predictor of Postoperative In-hospital Mortality in Adult Congenital Heart Disease Patients at Haji Adam Malik General Hospital Medan

  • Juang Idaman Zebua Universitas Sumatera Utara
  • Ali Nafiah Nasution Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia.
  • Andre Pasha Ketaren Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia.
  • Harris Hasan Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia.
  • Nizam Zikri Akbar Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia.
Keywords: PEACH Score, mortality, adult congenital heart disease, validation

Abstract

Introduction: Congenital heart disease (CHD) is an abnormality in the structure and function of the heart that is acquired while still intrauterine where the incidence of CHD worldwide is estimated at around 8 cases per 1,000 live births. Even though the development of the medical science is currently advanced, there are still CHD patients who are lately diagnosed and found when the patient is an adult so it requires surgical interventions. The PEACH score is a score that can predict postoperative in-hospital mortality in adults CHD patients. This study aims to validate the PEACH score.

Methods: This is a retrospective cohort study of 52 adult patients with CHD who underwent surgery at Haji Adam Malik General Hospital from January 2019 to April 2023. Validation was analyzed using a calibration and discrimination test to the PEACH score in predicting postoperative in-hospital mortality.

Result: The incidence of in-hospital mortality was 8 (15.4%) patients. There is a relationship between the PEACH score group and the incidence of mortality (p=0.006). The results of the calibration test using the Hosmer and Lameshow analysis and the discrimination test using the Receiver Operating Characteristic analysis showed good validation (p=0.85; AUC=0.83).

Conclusion: The PEACH score is valid for predicting postoperative in-hospital mortality in adult congenital heart disease at Haji Adam Malik General Hospital.

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References

1. Roebiono P, Yuniadi Y, Hermanto D, Siswanto B. Buku Ajar Kardiovaskular Jilid 2. Jakarta: Sagung Seto. 2007. 513 p.
2. Ntiloudi D, Gatzoulis M, Arvanitaki A, Karvounis H, Giannakoulas G. Adult congenital heart disease: Looking back, moving forward. International Journal of Cardiology Congenital Heart Disease. Desember 30; 2(2021): 1-6.
3. Cahyono A, Rachman MA. Distribusi kematian penyakit jantung bawaan di instalasi rawat inap anak rumah sakit dokter soetomo tahun 2004,2005 dan 2006. Jurnal Kardiologi Indonesia 2007;28:280-4.
4. Constantine A, Costola G, Bianchi P, Chessa M, Giamberti A, Kempny A, et al. Enhanced assessment of perioperative mortality risk in adults with congenital heart disease. Journal of the American College of Cardiology. 2021;78(3):234–42.
5. Hariyanto D. Profil Penyakit Jantung Bawaan di Instalasi Rawat Inap Anak RSUP Dr.M. Djamil Padang Januari 2008 – Februari 2011. Sari Pediatri. Oktober 2012; 14(3). 152-57.
6. Rahajoe A, Roebiono P, Harimurti G. Panduan Tatalaksana Penyakit Jantung Bawaan Dewasa (PJBD). Kelompok Kerja Kardiologi Pediatrik dan Penyakit Jantung Bawaan Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. 2020. 44-55.
7. Bredy C, Ministeri M, Kempny A, Alonso-Gonzalez R, Swan L, Uebing A, Diller GP, Gatzoulis MA, Dimopoulos K. New York Heart Association (NYHA) classification in adults with congenital heart disease: relation to objective measures of exercise and outcome. Eur Heart J Qual Care Clin Outcomes. 2018 Jan 1;4(1):51-58.
8. Dimopoulos K, Diller GP, Giannakoulas G, Petraco R, Chamaidi A, Karaoli E, Mullen M, Swan L, Piepoli MF, Poole-Wilson PA, Francis DP, Gatzoulis MA. Anemia in adults with congenital heart disease relates to adverse outcome. J Am Coll Cardiol. 2009 Nov 24;54(22):2093-100.
9. Rajpal S., Alshawabkeh L., Almaddah N., Joyce C. M., Shafer K., Gurvitz M., et al. Association of albuminuria with major adverse outcomes in adults with congenital heart disease: Results from the Boston adult congenital heart biobank. JAMA Cardiol. 2018; 3 (4), 308–316.
10. El Sayegh S, Ephrem G, Wish JB, Moe S, Lim K. Kidney disease and congenital heart disease: Partnership for life. Front Physiol. 2022 Aug 19;13:970389.
11. Fuhrman D. Y., Nguyen L., Joyce E. L., Priyanka P., Kellum J. A. Outcomes of adults with congenital heart disease that experience acute kidney injury in the intensive care unit. Cardiol. Young. 2021; 31 (2), 274–278.
12. Kwiatkowski D. M., Price E., Axelrod D. M., Romfh A. W., Han B. S., Sutherland S. M., et al. Incidence, risk factors, and outcomes of acute kidney injury in adults undergoing surgery for congenital heart disease. Cardiol. Young. 2017; 27(6), 1068–1075.
13. Maser M, Freisinger E, Bronstein L, Köppe J, Orwat S, Kaleschke G, Baumgartner H, Diller GP, Lammers A. Frequency, Mortality, and Predictors of Adverse Outcomes for Endocarditis in Patients with Congenital Heart Disease: Results of a Nationwide Analysis including 2512 Endocarditis Cases. J Clin Med. 2021 Oct 29;10(21):5071.
14. Chan A, Aijaz A, Zaidi AN. Surgical outcomes in complex adult congenital heart disease: a brief review. J Thorac Dis. 2020 Mar;12(3):1224-1234.
15. Holst KA, Dearani JA, Burkhart HM, Connolly HM, Warnes CA, Li Z, Schaff HV. Risk factors and early outcomes of multiple reoperations in adults with congenital heart disease. Ann Thorac Surg. 2011 Jul;92(1):122- 8; discussion 129-30.
16. Berra Zümrüt Tan-Recep, Eylem Tuncer, Nihat Cine, Hakan Ceyran. Evaluation of mortality scores in patients with adult congenital heart defects. Cardiovasc Surg Int 2022;9(2):73-80.
17. Robert B. Hawkins, Jeffrey M. Wilson, J. Hunter Mehaffey, Thomas A.E. Platts-Mills, Gorav Ailawadi. Safety of Intravenous Heparin for Cardiac Surgery in Patients With Alpha-Gal Syndrome, The Annals of Thoracic Surgery, Volume 111, Issue 6, 2021.
Published
2024-03-29
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How to Cite
Zebua, J., Nasution, A., Ketaren, A., Hasan, H., & Akbar, N. (2024). PEACH Score Validation as a Predictor of Postoperative In-hospital Mortality in Adult Congenital Heart Disease Patients at Haji Adam Malik General Hospital Medan. Indonesian Journal of Cardiology, 44(2), 61-7. https://doi.org/10.30701/ijc.1546