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LETTER TO EDITOR
Year : 2018  |  Volume : 13  |  Issue : 4  |  Page : 519
 

Acute neurological complications after congenital structural heart disease surgery


Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication25-Feb-2019

Correspondence Address:
Dr. Jogender Kumar
1044, Sector 15 B, Chandigarh 160015
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JPN.JPN_77_18

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How to cite this article:
Kumar J. Acute neurological complications after congenital structural heart disease surgery. J Pediatr Neurosci 2018;13:519

How to cite this URL:
Kumar J. Acute neurological complications after congenital structural heart disease surgery. J Pediatr Neurosci [serial online] 2018 [cited 2019 Mar 26];13:519. Available from: http://www.pediatricneurosciences.com/text.asp?2018/13/4/519/252767




Dear Editor

We read with great interest the article by Jafri et al.[1] in the recent issue of your journal. I would like to commend the authors for their endeavor to bring these data from developing countries, but at the same time have the following comments to offer, explanation to which will benefit the readership of the journal.

  1. The outcome of interest was “acute neurologic complications” but neither the parameters nor the time limit for classifying as acute is clearly defined in the methodology. Similarly, no reference is given for brain death criteria, which may vary in different countries.[2],[3]It is important to have clear definitions for improving the generalizability and external validity of the study.


  2. There are multiple mistakes in the presentation of the data in results. In Table 1, age with interquartile range is not given. The authors did not mention unit of age as well as the length of the stay. Also, the mean length of hospital stay described in the abstract/text and Table 1 did not match. In Table 2, the number of patients (n) is not mentioned and for each heading the (n) is different. So, it leaves reader to wonder for the denominator.


  3. In Table 2, the authors state clinical seizure in 28.2000 and altered consciousness in 5.2000, similarly for stroke, brain death, and so on. What is the meaning of these values? The number of children presented in decimal points?


  4. The authors described the intake of the number of antiepileptic drugs. The point of interest for the reader will be the name of the drug used as a first and second line, which can help in the future management of such patients in other similar setups.


  5. In discussion, the authors begin the point that this study has shown that increasing cardiopulmonary bypass time and vasoactive inotropic score are significantly associated with mortality in this patient cohort. However, there is no such data in results. Also, each statement must be supported by statistical measure before stating it as significant. This observation is very relevant and the authors must provide data on it.


  6. Similarly, in discussion, the authors stated that they found a significant association between the length of stay and neurological complications. However, there is no supporting data for this statement in the entire manuscript.


  7. In Tables 1 and 2, the data presented as mean ± SD are skewed, so median should be used.[4]



   Financial support and sponsorship Top


Nil.


   Conflicts of interest Top


There are no conflicts of interest.



 
   References Top

1.
Jafri SK, Ehsan L, Abbas Q, Ali F, Chand P, Ul Haque A. Frequency and outcome of acute neurologic complications after congenital heart disease surgery. J Pediatr Neurosci 2017;12:328-31.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Nakagawa TA, Ashwal S, Mathur M, Mysore M; Committee for Determination of Brain Death in Infants Children. Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations—executive summary. Ann Neurol 2012;71:573-85.  Back to cited text no. 2
    
3.
Goila AK, Pawar M. The diagnosis of brain death. Indian J Crit Care Med 2009;13:7-11.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Manikandan S. Measures of central tendency: median and mode. J Pharmacol Pharmacother 2011;2:214-5.  Back to cited text no. 4
[PUBMED]  [Full text]  




 

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