IJCS | Volume 33, Nº4, July and August 2020

334 Table 3 - Frequency of deaths in patients admitted to a pediatric cardiac intensive care unit by age, sex, nutritional profile (Z-score), diagnosis, treatment and extracorporeal circulation time (2013-2014) Category Deaths (n = 34) p* Yes n (%) No n (%) Age (n = 307) < 28 days 7 (20.6%) 19 (7.0%) 0.001 > 28 days and ≤ 1 year 21 (61.8%) 114 (41.8%) > 1 year ≤ 5 years 5 (14.7%) 43 (15.8%) > 5 years 1 (2.9%) 97 (31.9%) Sex (n = 307) Female 15 (44.1%) 131 (48.0%) 0.670 Male 19 (55.9%) 142 (52.0%) BMI for age (Z score) (n = 307) Underweight 13 (38.2%) 95 (34.8%) 0.542 Wasting 5 (14.7%) 56 (20.5%) Normal 14 (41.2%) 90 (33.0%) Overweight 2 (5.9%) 32 (11.7%) Diagnosis (n = 307) Acquired heart disease 2 (5.9%) 23 (8.4%) 0.609 Congenital heart disease 32 (94.1%) 250 (91.6%) Congenital heart disease (n = 282) Acyanotic 10 (31.2%) 141(56.4%) 0.007 Cyanotic 22 (68.8%) 109 (43.6%) Treatment (n = 307) Acquired heart disease (n = 25) Clinical 1 (50%) 8 (34.8%) 0.145 Surgical 0 (0%) 13 (56.5%) Percutaneous 1 (50%) 2 (8.7%) Congenital heart disease (n = 282) Clinical 11 (34.4%) 63 (25.2%) 0.441 Surgical 20 (62.5%) 170 (68.0%) Percutaneous 1 (3.1%) 17 (6.8%) ECC time (n = 138) < 90 minutes 4 (23.5%) 68 (56.2%) 0.018 90 - 120 minutes 4 (23.5%) 25 (20.7%) > 120 minutes 9 (52.9%) 28 (23.1%) BMI: body mass index; ECC: extracorporeal circulation; (*) Pearson’s chi-square test; p-values < 0.05 were considered statistically significant. Guimarães & Guimarães Profile of a pediatric cardiac ICU Int J Cardiovasc Sci. 2020; 33(4):331-336 Original Article Of 307 patients, 11.1%died and 88.9%were discharged from the ICU. Cardiogenic shock was the cause of 61.8% of deaths, followed by septic shock (35.5%) and coagulation disturbances (2.9%). A robust association was found between age and death (p = 0.001) (Table 3). The type of heart disease (p = 0.004) and the use of ECC were also associated with hospital mortality; however, after logistic modelling, only age (adjusted OR = 2.706; p = 0.001) and diagnosis of congenital heart diseases (adjusted OR = 0.363; p = 0.001) were associated with hospital mortality. Bivariate analysis was not performed for acquired heart diseases, as they constituted only one category, which made the crossing of data impossible. The RACHS-1, adjusted for congenital heart diseases, was used in 190 patients. In category 1 (21.1%), the most frequent were PAC (43.6%) and IAC (41%) surgical treatments. In category 2 (50%), the total surgical repair of tetralogy of Fallot (35.7%) was the most common procedure. In category 3 (44.9%), the systemic-to- pulmonary shunt (modified Blalock-Taussig shunt) was the most common procedure (33.7%), and in category 4 (13%), Rastelli operation (30.8%) was themain procedure. No intervention was classified as category 5 or 6. The highest percentage of deaths (38.5%) occurred in category 4, as described in Table 4. Discussion The present study evidenced a high prevalence of children coming from the countryside of Bahia state. This is probably due to a lack of specialized services in pediatric cardiology for an early diagnosis and treatment of these patients in the cities of origin. Previous studies corroborate this finding. 15-19 The predominance of men and infants younger than one year was also similar to previous studies. 15,16,19-22 In developed countries, Kawasaki disease is the main cause of acquired heart disease, notably in Japan and in the USA, with incidence varying from3 to 112 per 100,000 children younger than five years old. 9 In underdeveloped and developing countries, rheumatic carditis is the main cause of acquired heart disease, as in Brazil. 10-12 In the present study, acquired heart disease accounted for 8.1%, with rheumatic heart disease as the main cause. Similar results were reported by Miyague et al. 23 In the study population, heart valve lesions accounted for 52% of rheumatic heart diseases treated surgically,