(183) Audit of Mortality Causes and Practices on Children With Heart Diseases at Jakaya Kikwete Institute

Introduction: Congenital heart diseases are serious and common conditions that have a significant impact on morbidity, mortality and health care cost in children, it is estimated that at least 32,000 infants in the US will be affected each year, and around 25% or 2.4 per 1000 live births require invasive treatment in the first year of life which poses a significant mortality burden.
Children with cardiac diseases are at high risk of cardiac failure, arrhythmia, cardiac arrest and death with reported incidence of In hospital cardiac arrest and mortality varying among different hospitals ranging from 2.6 up to 12.7%, few data on causes of mortality, clinical practices and deaths audits standardized tools poses a challenge in proper case reviews and in telling an accurate story on actual causes of deaths which leads to poor quality of care and continuing occurrence of preventable deaths in day-to-day life.

Methods: A retrospective study from January 2022 to May 2023 was done on the causes, and clinical practices on mortality cases in admitted children with heart diseases.

Results: Overall In hospital mortality rate was 8.9%, there was a male predisposition of 55.9%, more death observed at age between 1 month to 1 year 67.6%, and during working hours 65.6%, prolonged hospital stay > 7 days 28.8%, mechanical ventilation >3 days, Cardiopulmonary bypass time >120 mins 28%, Aortic cross clamp time > 60 mins 20% had higher mortality rates, cardiac diagnoses in deceased patients were Transposition of great arteries 19(15.9%), Tetralogy of Fallot 16 (13.2%), AVSD 12 (9.9%), PDA 10(8.3%), ASD 10(8.8%), tricuspid atresia 8(6.6%), and VSD, immediate causes of deaths were septic shock 30(27.1%), respiratory failure 26 (23.4%), cardiogenic shock 13(11.7%), severe metabolic acidosis 15 (13.3%), there was discrepancy in vital monitoring and management escalations in more than half of deceased patients.

Conclusions: Pediatric mortality audits are accessible indicators of trends in the provision of care in children with heart diseases, early detection of critical congenital heart diseases, infection control and a system of timely recognition of patient clinical deteriorations relies on regular vital signs monitoring for early management escalations in critically ill patients to prevent future adverse events and deaths.