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Pediatric Surgery International

Erschienen in:

02.03.2022 | Original Article

An analysis of neonatal mortality following gastro-intestinal and/or abdominal surgery in a tertiary hospital in South Africa

verfasst von: Thozama Siyotula, Marion Arnold

Erschienen in: Pediatric Surgery International | Ausgabe 5/2022

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Abstract

Purpose

Thirty-day, 6-month and 12-month post-operative mortality and assessment of factors associated with 30 day post-operative mortality were ascertained.

Method

A retrospective medical record audit for neonates who underwent gastrointestinal or abdominal wall surgery within the neonatal period at a tertiary free standing paediatric hospital during the 12-year period from 1 January 2007 to 31 December 2018.

Results

The 30-day post-operative mortality rate was 83/762 (11%). Mortality resulted from: sepsis (74%), palliation due to ultra-short bowel length (12%), ventilation-associated pneumonia (10%), associated congenital cardiac lesions (3%) and intestinal failure-associated liver disease (1%). Surgery for necrotizing enterocolitis had the greatest 30-day post-operative mortality (28%). Most neonates (69%) who died were prematurely born. Mean age at surgery was ten days and mean age at death was six days. Abdominal compartment syndrome was noted post operatively in 15% patients. Risk factors for sepsis included central line-associated bloodstream infections (65%), respiratory tract infections (41%) and surgical complications [anastomotic breakdown (7%) and wound infection (24%)]. Mortality in patients from referral hospitals more than an hour’s drive away was high (15/39, 38%).

Conclusion

Mortality is double that of high-income countries, although significantly lower than most African settings. Strategic quality-improvement interventions are required to optimize outcomes.

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Titel: An analysis of neonatal mortality following gastro-intestinal and/or abdominal surgery in a tertiary hospital in South Africa
verfasst von: Thozama Siyotula
Marion Arnold
Publikationsdatum: 02.03.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 5/2022
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05100-7

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