{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T02:32:39Z","timestamp":1784687559617,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite advancements in surgical techniques and perioperative care, pediatric cardiac patients remain at an increased risk of adverse events. The APRICOT (2017) study aimed to establish the incidence of severe critical events in children undergoing anesthesia in Europe, while the NECTARINE (2021) study aimed to assess anesthesia practices and outcomes in neonates and infants under 60\u2009weeks postconceptual age. Our goal was to conduct a secondary analysis of the cardiac cohorts from these two studies to determine mortality rates and other outcomes after cardiac procedures at 30 and 90\u2009days, identify factors influencing mortality, illustrate clinical practices, and assess the methodology of the two studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sub\u2010analysis of the data from APRICOT and NECTARINE. Data representativity was assessed through a systematic categorization process. European countries were divided into four income groups based on their gross national income per capita. Subsequently, the total number of patients across all four income groups was calculated for both the Apricot and Nectarine studies, and then the specific contribution of each income group to the total population of each study was determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This analysis comprised 1016 cases (Apricot, <jats:italic>n<\/jats:italic>\u2009=\u2009476 and Nectarine, <jats:italic>n<\/jats:italic>\u2009=\u2009540). There was a considerable variability in clinical practice in Europe. The overall mortality rates were 0.84% (APRICOT) and 8.1% (NECTARINE). In both cohorts, substantial mortality was observed among low\u2010age and low\u2010weight infants. Stratifying the participating countries by income illustrated that the data originated from highest\u2010income and upper\u2010middle\u2010income European countries and were not representative of low\u2010income and middle\u2010income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this secondary analysis of the APRICOT and NECTARINE studies, we found that fatal cases primarily occurred in low\u2010age and low\u2010weight neonates and infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Editorial comment<\/jats:title><jats:p>This secondary analysis of the APRICOT and NECTARINE studies focused on pediatric cardiac surgical cases. Outcomes differed according to weight and age of the children, where mortality risk was higher for very young and low\u2010weight children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14585","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T04:19:32Z","timestamp":1738210772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical practice and outcomes in European pediatric cardiac anesthesia: A secondary analysis of the APRICOT and NECTARINE studies"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6387-8855","authenticated-orcid":false,"given":"Albert Gyllencreutz","family":"Castellheim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Institution of Clinical Sciences, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Region V\u00e4stra G\u00f6taland Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Habre","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-9768","authenticated-orcid":false,"given":"Tom Giedsing","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Akershus University Hospital  L\u00f8renskog Norway"},{"name":"Faculty of Medicine, Institute of Clinical Medicine Oslo University  Oslo 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