Paediatrica Indonesiana
Vol 58 No 5 (2018): September 2018

Low peripheral oxygen saturation as a risk factor for brain abscess in children with cyanotic congenital heart disease

Nadia Qoriah Firdausy (Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java)
Indah Kartika Murni (Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java)
Agung Triono (Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java)
Noormanto Noormanto (Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java)
Sasmito Nugroho (Department of Child Health, Universitas Gadjah Mada Medical School/Dr. Sardjito Hospital, Yogyakarta, Central Java)



Article Info

Publish Date
17 Oct 2018

Abstract

Background Brain abscess is a severe infection of brain parenchyma, which occurs in 25-46% of cases of uncorrected cyanotic congenital heart disease. Low arterial oxygen saturation is the main risk factor for brain abscess in children with cyanotic congenital heart disease, however, the arterial oxygen saturation test is invasive and not routinely done in our setting. Objective To evaluate low peripheral oxygen saturation as a risk factor for brain abscess in children with cyanotic congenital heart disease. Methods We conducted a matched, case-control study at Sardjito Hospital, Yogyakarta for children aged less than 18 years with cyanotic congenital heart disease, from 2010-2016. Case subjects were children with brain abscess complications. The control group had only cyanotic congenital heart disease, and were matched for age and sex to the case group. During hospitalization due to the brain abscess complication in the case group, data regarding peripheral oxygen saturation, polycythemia, pneumonia, sepsis, dental caries and restricted pulmonary blood flow were collected and compared between both groups. Results During the study period, 18 children with cyanotic congenital heart disease had brain abscesses. This group was compared to the control group of 36 children. Bivariate analysis revealed that the lowest level of peripheral oxygen saturation (OR 0.92; 95%CI 0.85 to 0.98; P=0.02) and dental caries (OR 3.3; 95%CI 1.01 to 11.18; P=0.04) were significant risk factors for brain abscess. However, in the multivariate analysis, the only statistically significant risk factor associated with brain abscess was the lowest level of peripheral oxygen saturation (OR 0.92; 95%CI 0.86 to 0.99; P=0.04). Conclusion Low peripheral oxygen saturation is a significant risk factor for brain abscess development in children with cyanotic congenital heart disease. A decrease of 1% peripheral oxygen saturation may increase the risk of brain abscess by 8%.

Copyrights © 2018






Journal Info

Abbrev

paediatrica-indonesiana

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of ...