Year: 2024
Type: article
Study design: Observational Study
Abstract: Background: Neonatal surgery remains a high-risk procedure.It requires multidisciplinary management and depends on the healthcare team's skills.This study aimed to describe our experience managing newborns requiring surgical interventions and investigate the main predictors of postoperative mortality. Methods:In this observational study, we included all newborns aged less than 28 days who were operated on in the pediatric surgery department under general anesthesia with tracheal intubation for major-risk surgery.Patients were divided into two groups according to the final issue (survival or death) during the two months following surgery.After comparing the two groups, univariable and multivariable logistic regression were done to investigate the predictors of perioperative mortality among neonates.Results: In this study, sixty-seven newborns were included.The incidence of early mortality was 28.3%.The anesthesia management had no impact on neonatal mortality.The main predictors of neonatal mortality were: revision surgery [aOR = 35.5;95% CI: 1.33-94.1],duration of surgery ≥120 min [aOR = 36.5;95% CI: 1.48-312], preoperative mechanical ventilation [aOR = 3.88; 95% CI: 1.12-30.8],and the incidence of peroperative adverse events [aOR = 5.7; 95% CI: 1-29.5] or postoperative surgical complication [aOR = 32.5;95% CI: 1.05-101].Conclusions: The early mortality rate after major neonatal surgery remains high in our department.It seems that preoperative poor conditions can increase the risk.Furthermore, major-risk surgeries requiring long-duration procedures and revision surgery, as well as the incidence of postoperative infection, can significantly increase the risk of neonatal mortality.
Source: Pediatric Anesthesia
DOI: 10.1111/pan.15004
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4404327942