Prevalência das cardiopatias congênitas em crianças e adolescentes com Síndrome de Down acompanhados em serviço de referência de cardiologia pediátrica
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Data
2023-07-20
Autores
Castropil, Yuri
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Universidade Estadual Paulista (Unesp)
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INTRODUÇÃO: A Síndrome de Down (SD) é uma síndrome genética com alta prevalência mundial. Os pacientes com esta condição apresentam peculiaridades clínicas, incluindo a associação com inúmeras comorbidades que requerem maior atenção e cuidado na assistência médica. Dentre elas, as Cardiopatias Congênitas (CC) destacam-se na população com SD, tanto pela alta prevalência (40- 65%), quanto por sua influência na qualidade e expectativa de vida desta população. OBJETIVOS: Identificar a prevalência das diferentes CC na população de SD atendida em ambulatório de cardiologia pediátrica e analisar possíveis fatores relacionados ao prognóstico. METODOLOGIA: Trata-se de estudo clínico observacional de corte transversal retrospectivo. Foram coletados dados de crianças e adolescentes com SD acompanhados em ambulatório de cardiologia pediátrica no período de 01 de janeiro de 1996 a 31 de dezembro de 2020, por meio da utilização de banco de dados da disciplina de Cardiologia Pediátrica. Os dados coletados dos prontuários dos pacientes foram compilados em planilha eletrônica para análise estatística. Não houve critérios de exclusão, considerando que foram incluídos apenas pacientes com diagnóstico síndrômico exclusivo de SD com CC diagnosticadas em ecocardiografia. RESULTADOS: Analisamos 154 pacientes, 75 do sexo masculino e 79 feminino, com diferença estatística quanto à idade, peso e comprimento na admissão sendo menores no sexo feminino. O peso no momento cirúrgico apresentou associação com a mortalidade, sendo menor nos pacientes que evoluíram para óbito. O Defeito do septo atrioventricular (DSAV) total foi a cardiopatia mais prevalente e a única que apresentou associação estatística com mortalidade. CONCLUSÃO: A CC mais frequente foi o DSAV, em acordo com os principais dados de literatura, seguida da persistência do canal arterial (PCA). O DSAV total e o menor peso cirúrgico tiveram associação com maior mortalidade. Não ocorreu associação das demais comorbidades e condições com o desfecho óbito.
INTRODUCTION: Down Syndrome (DS) is a genetic syndrome with a high prevalence worldwide. Patients with this condition have clinical peculiarities, including association with numerous comorbidities, which require greater attention and medical care. Among them, Congenital Heart Defects (CHDs) stand out in the population with DS, both for their high prevalence (40-65%) and for their influence on the quality and life expectancy of this population. OBJECTIVES: Identify the prevalence of different CCs in the DS population attended at a pediatric cardiology outpatient clinic and to analyze possible factors related to good or bad prognosis. METHODOLOGY: This is a retrospective cross-sectional observational clinical study. Data were collected from children and adolescents with DS followed up at a pediatric cardiology outpatient clinic from January 1, 1996 to December 31, 2020, using the database of the Pediatric Cardiology discipline. Data collected from patients' medical records were compiled in an electronic spreadsheet for statistical analysis. There were no exclusion criteria, considering that only patients diagnosed with DS with congenital heart diseases were included. RESULTS: We analyzed 154 patients, 75 males and 79 females, with statistical differences regarding age, weight and length at admission being smaller in females. Weight at the time of surgery was associated with mortality, being lower in patients who died. Total atrioventricular septal defect (AVSD) was the most prevalent heart disease and the only congenital heart disease that was statistically associated with mortality. CONCLUSION: The most frequent CC was AVSD, according to the main literature data, followed by patent ductus arteriosus (PDA). Total AVSD and surgical weight were associated with mortality. There was no association of other comorbidities and conditions with death outcome.
INTRODUCTION: Down Syndrome (DS) is a genetic syndrome with a high prevalence worldwide. Patients with this condition have clinical peculiarities, including association with numerous comorbidities, which require greater attention and medical care. Among them, Congenital Heart Defects (CHDs) stand out in the population with DS, both for their high prevalence (40-65%) and for their influence on the quality and life expectancy of this population. OBJECTIVES: Identify the prevalence of different CCs in the DS population attended at a pediatric cardiology outpatient clinic and to analyze possible factors related to good or bad prognosis. METHODOLOGY: This is a retrospective cross-sectional observational clinical study. Data were collected from children and adolescents with DS followed up at a pediatric cardiology outpatient clinic from January 1, 1996 to December 31, 2020, using the database of the Pediatric Cardiology discipline. Data collected from patients' medical records were compiled in an electronic spreadsheet for statistical analysis. There were no exclusion criteria, considering that only patients diagnosed with DS with congenital heart diseases were included. RESULTS: We analyzed 154 patients, 75 males and 79 females, with statistical differences regarding age, weight and length at admission being smaller in females. Weight at the time of surgery was associated with mortality, being lower in patients who died. Total atrioventricular septal defect (AVSD) was the most prevalent heart disease and the only congenital heart disease that was statistically associated with mortality. CONCLUSION: The most frequent CC was AVSD, according to the main literature data, followed by patent ductus arteriosus (PDA). Total AVSD and surgical weight were associated with mortality. There was no association of other comorbidities and conditions with death outcome.
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Cardiopatia congênita, Síndrome de Down, Pediatria, Mortalidade, Prognóstico, Congenital heart disease, Down's syndrome, Pediatrics, Mortality, Prognosis