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SYSTEMATIC REVIEW article

Front. Pediatr.
Sec. Pediatric Cardiology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1508329

Biomarkers Predicting Postoperative Adverse Outcomes in Children with Congenital Heart Disease: A Systematic Review and Meta-Analysis

Provisionally accepted
Shifan Zhou Shifan Zhou Song Feng Ma Song Feng Ma *Lu Liu Lu Liu Xiaochuang Jin Xiaochuang Jin Daniel Dorikun Daniel Dorikun
  • First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

The final, formatted version of the article will be published soon.

    Abstract Objective: To statistically analyze biomarkers predicting postoperative outcomes in children with congenital heart disease (CHD). Methods: PubMed, Embase, Cochrane Library, and Web of Science were performed to search up to February 2024. The measured outcomes were biomarkers, mortality, length of hospital stay, complication rates, and infection rates. Adults with CHD were excluded. Standard deviation or odds ratio (OR) with 95% confidence interval (95% CI) were extracted. A random-effects model synthesized SMDs or ORs with 95% CIs. Sensitivity analysis investigated heterogeneity, and Egger's test assessed publication bias. Results: Seventeen eligible articles were included, the biomarkers involved include serum lactate, NT-Pro BNP, PaO2, serum creatinine, C1-INH activity, ST2, serum chloride concentration, GH, glycemia, cTOI, NLR, serum albumin, and glucose levels, with 2,888 patients who underwent surgery(modified Norwood procedure, arterial switch procedure, biventricular repair etc.). Serum lactate was higher in the postoperative death group (SMD: 1.18, 95% CI: 0.59-1.77). Lower postoperative N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels were associated with lower mortality (OR: 0.23, 95% CI: 0.08-0.68) and shorter mechanical ventilation time (OR: 0.40, 95% CI: 0.18-0.90). Higher serum albumin levels were associated with longer hospital stays (OR: 3.12, 95% CI: 1.66-5.84). Significant heterogeneity was found in serum creatinine, B-type natriuretic peptide (BNP), serum lactate, and NT-Pro BNP. Publication bias was detected in some studies. Conclusion: Serum lactate, NT-Pro BNP, and serum albumin are reliable biomarkers for predicting adverse outcomes in children with CHD after surgery.

    Keywords: congenital heart disease (CHD), biomarkers, postoperative outcomes, metaanalysis, pediatric cardiac surgery

    Received: 09 Oct 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Zhou, Ma, Liu, Jin and Dorikun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Song Feng Ma, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.