Abstract / Summary
Abstract Ventricular septal defect (VSD) is the most common congenital cardiac anomaly requiring surgical intervention. Although surgical outcomes have improved worldwide, complication rates continue to vary across regions. In Ethiopia, evidence on postoperative outcomes following VSD repair is limited. Understanding risk factors in low-resource settings that can occur pre-, intra-, and post-surgery is essential to improving care and reducing postoperative morbidity. Therefore, this study aims to determine the magnitude and risk factors of major adverse events (MAEs) and postoperative treatment outcomes. A retrospective cross-sectional study was conducted among children (< 18 years) who underwent surgical closure of simple VSD at the Cardiac Center of Ethiopia between January 1, 2009, and December 30, 2024. All eligible subjects during this period were included, yielding a total sample of 306 patients. Data were extracted from medical records using a structured checklist, then checked for completeness, cleaned, and analyzed using SPSS version 25. Bivariable logistic regression was first conducted; variables with a p-value < 0.2 were entered into the multivariable logistic regression model. Adjusted odds ratios (AORs) with 95% confidence intervals were reported, and statistical significance was determined at p < 0.05. A total of 306 patients were included in the study, of whom 51% were male. The median age was 5 years (IQR: 3- 8). Mortality occurred in 2 patients (0.7%). In the multivariable analysis, male sex (AOR = 4.29; 95% CI: 1.78–10.32) and large VSD size (AOR = 5.90; 95% CI: 1.37–25.83) were identified as significant predictors of MAEs. Longer aortic cross-clamp time (CCT) (AOR = 1.015; 95% CI: 1.01–1.031) and prolonged cardiopulmonary bypass (CPB) duration (AOR = 1.02; 95% CI: 1.006–1.03) were significantly associated with extended mechanical ventilation. CPB duration (AOR = 1.02; 95% CI: 1.005–1.03) also independently predicted prolonged intensive care unit (ICU) stay. Additionally, large VSD size was associated with longer hospital stay (AOR = 3.2; 95% CI: 1.09–9.47). Children undergoing simple VSD repair in Ethiopia experience a notable rate of major adverse events. Male sex and large VSD size were key predictors of major adverse events. Large defect size and preoperative complications were associated with prolonged hospitalization, while extended bypass and CCT contributed to longer ventilation and ICU stays.