Prediction model for cardiac arrest after surgery in pediatric congenital heart disease

WANG Shuang; WANG Xiao-jun; LIU Ai-hong; SHEN Zheng-li; HAO Xue-mei

doi:10.11659/jjssx.07E025110

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Prediction model for cardiac arrest after surgery in pediatric congenital heart disease

Cardiovascular Surgery Column | 更新时间：2026-03-09

- Prediction model for cardiac arrest after surgery in pediatric congenital heart disease
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 2, Pages: 104-108(2026)
- 作者机构：
  
  1.中国人民解放军总医院第七医学中心麻醉科，北京 100700
  2.中国人民解放军总医院第七医学中心儿童重症监护室，北京 100700
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.07E025110
  CLC： R541.7+8
- Received：28 July 2025，
  
  Published：25 February 2026
- 稿件说明：
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王霜,王筱君,刘爱红等.小儿先天性心脏病术后心脏骤停预测模型的构建[J].局解手术学杂志,2026,35(02):104-108.

WANG Shuang,WANG Xiao-jun,LIU Ai-hong,et al.Prediction model for cardiac arrest after surgery in pediatric congenital heart disease[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):104-108.
王霜,王筱君,刘爱红等.小儿先天性心脏病术后心脏骤停预测模型的构建[J].局解手术学杂志,2026,35(02):104-108. DOI： 10.11659/jjssx.07E025110.

WANG Shuang,WANG Xiao-jun,LIU Ai-hong,et al.Prediction model for cardiac arrest after surgery in pediatric congenital heart disease[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):104-108. DOI： 10.11659/jjssx.07E025110.

摘要

目的

基于基线资料与超声组学分析小儿先心病术后心脏骤停的影响因素。

方法

选取2020年2月至2025年2月我院收治的先心病患儿993例，根据术后30 d是否发生心脏骤停分为发生组、未发生组。采用

LASSO

回归模型初步筛选变量后，采用

Logistic

回归模型分析术后心脏骤停的影响因素；建立对应的预测模型，分别采用受试者工作特征（

ROC

）曲线、校准曲线验证模型效能。

结果

术后30 d心脏骤停发生率为5.14%。

LASSO

回归模型筛选出5个核心变量，经

Logistic

回归模型分析显示，先心病手术风险分级第一版（RACHS-1）等级≥4级、心肺转流（CPB）时间较长、二尖瓣舒张早期血流速度/二尖瓣环舒张早期运动速度（E/e'）比值较大、三尖瓣反流峰值流速（TR Vmax）较大均是小儿先心病术后心脏骤停的危险因素（

0.05），而左室整体纵向应变（LVGLS）绝对值较大是保护因素（

0.05）。基于上述因素建立预测模型预测术后心脏骤停的风险；模型预测术后心脏骤停的曲线下面积（

AUC

）为0.928，敏感度为92.16%，特异度为84.39%；

Hosmer

Lemeshow

检验显示，该模型对小儿先心病术后心脏骤停的预测概率与实际概率比较，差异无统计学意义（

=0.415，

=0.296）。

结论

RACHS-1等级≥4级、CPB时间较长、E/e'比值较大、TR Vmax较大是小儿先心病术后心脏骤停的危险因素，LVGLS绝对值较大是其保护因素，融合上述基线资料和超声组学指标构建的预测模型具有良好的效能。

Abstract

Objective

To analyze the influencing factors for postoperative cardiac arrest in children with congenital heart disease based on the baseline clinical data and ultrasomics.

Methods

A total of 993 pediatric patients with congenital heart disease who were admitted to our hospital from February 2020 to February 2025 were enrolled.They were categorized into the event group and the non-event group according to the occurrence of cardiac arrest within 30 days after surgery. Variables were initially screened using

LASSO

regression model，and subsequently analyzed using multivariate

Logistic

regression to identify the independent risk factors. A corresponding risk prediction model was established， and the model performance was validated using the

receiver operating characteristic

（

ROC

） curve and calibration curve.

Results

The incidence of cardiac arrest within 30 days after surgery was 5.14%. Five core variables were screened out by the

LASSO

regression model.

Logistic

regression analysis identified that risk adjustment for congenital heart surgery 1st version （RACHS-1） category≥4，longer cardiopulmonary bypass （CPB） time，greater early diastolic mitral inflow velocity/early diastolic mitral annular velocity （E/e′），and higher tricuspid regurgitation peak velocity （TR Vmax） were the independent risk factors for postoperative cardiac arrest （

0.05），while a greater absolute value of left ventricular global longitudinal strain （LVGLS） was identified as a protective factor （

0.05）.A corresponding risk prediction model was established. The

area under the curve

（

AUC

） of the model for predicting postoperative cardiac arrest was 0.928，with a sensitivity of 92.16% and a specific

ity of 84.39%.The

Hosmer

Lemeshow

test indicated no significant difference between the predicted probability and actual probability for cardiac arrest after pediatric congenital heart disease surgery（

²=0.415，

=0.296）.

Conclusion

RACHS-1 category≥4，longer CPB time，a greater E/e' ratio，and a higher TR Vmax are the risk factors for cardiac arrest after pediatric congenital heart disease surgery，while a greater absolute value of LVGLS is a protective factor. The prediction model constructed by integrating the above baseline data and ultrasomics indicators demonstrates good performance.

关键词

Keywords

references

Needleman JS ， Whitehill RD ， Claxton JS ， et al . Risk of late sudden death after surgery for congenital heart disease ［J］. Cardiol Young ， 2025 ， 35 （ 4 ）： 805 - 811 . doi： 10.1017/S1047951125000277 http://dx.doi.org/10.1017/S1047951125000277 .

Zheng G ， Wang J ， Chen P ， et al . Epidemiological characteristics and trends in postoperative death in children with congenital heart disease （CHD）： a single-center retrospective study from 2005 to 2020 ［J］. J Cardiothorac Surg ， 2023 ， 18 （ 1 ）： 165 . doi： 10.1186/s13019-023-02224-2 http://dx.doi.org/10.1186/s13019-023-02224-2 .

Oztürk DY ， Oztürk E ， Ozcanoglu HD ， et al . Factors predicting early major adverse events in the intensive care unit after successful cardiac surgery for congenital heart disease in full-term neonates ［J］. Braz J Cardiovasc Surg ， 2023 ， 38 （ 5 ）： e20220442 . doi： 10.21470/1678-9741-2022-0442 http://dx.doi.org/10.21470/1678-9741-2022-0442 .

Hook JE ， Delany DR ， Buckley JR ， et al . Factors associated with mortality and adverse outcomes after truncus arteriosus repair ［J］. Ann Thorac Surg ， 2023 ， 116 （ 2 ）： 358 - 364 . doi： 10.1016/j.athoracsur. 2022.10.020 http://dx.doi.org/10.1016/j.athoracsur.2022.10.020 .

Wu Y ， Che S ， Li Y . An unusual cause of cardiac arrest in a young infant ［J］. BMC Cardiovasc Disord ， 2024 ， 24 （ 1 ）： 370 . doi： 10.1186/s12872-024-04028-1 http://dx.doi.org/10.1186/s12872-024-04028-1 .

Yang Y ， Long H ， Feng Y ， et al . A multi-omics method for breast cancer diagnosis based on metabolites in exhaled breath，ultrasound imaging，and basic clinical information ［J］. Heliyon ， 2024 ， 10 （ 11 ）： e32115 . doi： 10.1016/j.heliyon.2024.e32115 http://dx.doi.org/10.1016/j.heliyon.2024.e32115 .

Song X ， Xu H ， Wang X ， et al . Use of ultrasound imaging Omics in predicting molecular typing and assessing the risk of postoperative recurrence in breast cancer ［J］. BMC Womens Health ， 2024 ， 24 （ 1 ）： 380 . doi： 10.1186/s12905-024-03231-8 http://dx.doi.org/10.1186/s12905-024-03231-8 .

Li Z ， Wang K ， Qu J ， et al . Identification of novel biomarkers for malignant thyroid nodules： a preliminary study based on ultrasound omics ［J］. Ann Biomed Eng ， 2025 ， 53 （ 5 ）： 1192 - 1198 . doi： 10.1007/s10439-025-03698-y http://dx.doi.org/10.1007/s10439-025-03698-y .

魏翔，潘铁成 . 心血管外科疾病诊疗指南［M］. 北京：科学出版社， 2013 ： 37 - 38 .

Jenkins KJ ， Gauvreau K ， Newburger JW ， et al . Consensus-based method for risk adjustment for surgery for congenital heart disease ［J］. J Thorac Cardiovasc Surg ， 2002 ， 123 （ 1 ）： 110 - 118 . doi： 10.1067/mtc.2002.119064 http://dx.doi.org/10.1067/mtc.2002.119064 .

Dotson A ， Covas T ， Halstater B ， et al . Congenital heart disease ［J］. Prim Care ， 2024 ， 51 （ 1 ）： 125 - 142 . doi： 10.1016/j.pop.2023.07.007 http://dx.doi.org/10.1016/j.pop.2023.07.007 .

Fakhri D ， Damayanti NMAS ， Nurhanif M . Comparison of risk stratification scoring system as a predictor of mortality and morbidity in congenital heart disease patients requiring surgery ［J］. Ann Pediatr Cardiol ， 2023 ， 16 （ 5 ）： 349 - 353 . doi： 10.4103/apc.apc_142_23 http://dx.doi.org/10.4103/apc.apc_142_23 .

Furnaz S ， Shaikh AS ， Qureshi R ， et al . Factors associated with poor outcomes after congenital heart surgery in low-resource setting in Pakistan： insight from the IQIC registry - a descriptive analysis ［J］. BMJ Open ， 2023 ， 13 （ 12 ）： e078884 . doi： 10.1136/bmjopen-2023-078884 http://dx.doi.org/10.1136/bmjopen-2023-078884 .

Tanyildiz M ， Yetimakman AF ， Yazici MU ， et al . Effect of cardiopulmonary bypass on thiol/disulfide homeostasis in congenital heart surgery ［J］. Turk Gogus Kalp Damar Cerrahisi Derg ， 2023 ， 31 （ 4 ）： 454 - 466 . doi： 10.5606/tgkdc.dergisi.2023.25283 http://dx.doi.org/10.5606/tgkdc.dergisi.2023.25283 .

Ouyang R ， Leng S ， Chen L ， et al . Assessment of right ventricular diastolic function in pediatric patients with repaired tetralogy of Fallot by cardiovascular magnetic resonance and echocardiography ［J］. Eur Radiol ， 2024 ， 34 （ 8 ）： 5487 - 5500 . doi： 10.1007/s00330-023-10538-x http://dx.doi.org/10.1007/s00330-023-10538-x .

Pereira SS ， Jacquemyn X ， Kutty S . Echocardiographic markers at diagnosis of persistent pulmonary hypertension of the newborn ［J］. J Perinat Med ， 2024 ， 52 （ 9 ）： 991 - 1001 . doi： 10.1515/jpm-2023-0346 http://dx.doi.org/10.1515/jpm-2023-0346 .

沈俊飞，王昭军，冯雪虹，等 . 扩张型心肌病病人左室整体纵向应变与心功能及预后的关系［J］. 中西医结合心脑血管病杂志， 2023 ， 21 （ 9 ）： 1683 - 1686 . doi： 10.12102/j.issn.1672-1349.2023. 09.027 http://dx.doi.org/10.12102/j.issn.1672-1349.2023.09.027 .

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