Analytical Examination of Mortality and Morbidity in Open-Heart Surgery at National Cardiothoracic Centre, Lagos State University Teaching Hospital

Open-heart surgery represents the apex of cardiac surgical practice in Nigeria, and the National Cardiothoracic Centre at Lagos State University Teaching Hospital is one of the few institutions performing cardiopulmonary bypass procedures on the continent. This study analytically examines the morbidity and mortality patterns of open-heart surgical procedures at the National Cardiothoracic Centre. A retrospective cohort design is applied to surgical records of 280 adult patients who underwent open-heart surgery between 2017 and 2023. Variables include operative indication, cardiopulmonary bypass time, cross-clamp duration, intraoperative complications, postoperative atrial fibrillation, respiratory failure, acute kidney injury, stroke, mediastinitis, reoperation rate, ICU length of stay, and 30-day mortality. Logistic regression in SPSS identifies independent predictors of 30-day mortality. Kaplan-Meier curves estimate one-year survival by operative indication category. Available cardiothoracic surgery literature from South West Nigeria identifies rheumatic valvular heart disease and congenital defect correction as the dominant indications, with 30-day mortality rates reported between 8 and 15 percent, compared to 1 to 3 percent in high-income country benchmarks. The EuroSCORE II risk stratification tool provides the operative risk adjustment framework. Findings will support the centre's cardiac surgery quality programme and contribute to its application for Sub-Saharan African cardiac surgery benchmarking data. Keywords: open-heart surgery, cardiopulmonary bypass, cardiac surgery outcomes, Lagos, South West Nigeria.