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paediatrics cardiology

RACHS-1 — Risk Adjustment for Congenital Heart Surgery

Six-category risk-adjustment system for in-hospital mortality after congenital cardiac surgery in children (Jenkins 2002). Higher category = higher mortality.

Score interpretation

Categories 1–2 — Low risk (mortality <2%) 1–2

→ Routine paediatric cardiac surgery pathway. Standard ICU monitoring.

Categories 3–4 — Moderate risk (mortality 3–8%) 3–4

→ PICU post-op with extended monitoring. Multidisciplinary planning. Echo on day 1 and pre-discharge.

Categories 5–6 — High risk (mortality >10%) 5–6

→ Tertiary congenital cardiac centre with ECMO availability. Pre-op MDT, parental counselling. PICU bed and surgeon-anaesthetist availability before scheduling.

Interpretation bands for the RACHS-1. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.