Perioperative mortality in children in a tertiary teaching hospital in Nigeria: a prospective study

• Published in: World journal of pediatric surgery Vol. 4; no. 1; p. e000237
• Main Authors: Talabi, Ademola Olusegun, Ojo, Olugbenga Olalekan, Aaron, Olurotimi Idowu, Sowande, Oludayo Adedapo, Faponle, Folayemi Aramide, Adejuyigbe, Olusanya
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 23.03.2021; BMJ Publishing Group
• Subjects: Congenital diseases; Disease; General anesthesia; Health care access; Health insurance; Hospitals; Intensive care; Medical personnel; Mortality; Original Research; Pediatrics; Population; Sepsis; Surgery; Nigeria; anesthetics; sudden infant death
• ISSN: 2516-5410; 2096-6938; 2516-5410
• DOI: 10.1136/wjps-2020-000237

BackgroundPerioperative mortality is one of the tools that can help to assess the adequacy of healthcare delivery in a nation. This audit was conducted to determine the 24-hour, 7-day and 30-day perioperative mortality rates and the predictors of mortality in a pediatric surgical cohort.MethodsThis was a prospective study of children whose ages ranged from a few hours to 15 years and who were operated on between May 2019 and April 2020. The primary outcome was to determine the incidence of in-hospital perioperative mortality.ResultsA total of 530 procedures were done in 502 children. Their ages ranged from a few hours to 15 years with a median of 36 months. The 24-hour, 7-day and 30-day mortality rates were 113.2 per 10 000 procedures [95% confidence interval (CI) =40 to 210], 207.6 per 10 000 procedures (95% CI=110 to 320) and 320.8 per 10 000 procedures (95% CI=190 to 470), respectively. Congenital anomalies complicated by postoperative sepsis contributed to death in the majority of cases. The predictors of mortality were neonatal age group [adjusted odds ratio (AOR)=19.92, 95% CI=2.32 to 170.37, p=0.006], higher American Society of Anesthesiologists Physical Status III and above (AOR=21.6, 95% CI=3.05 to 152.91, p=0.002), emergency surgery (AOR=17.1, 95% CI=5.21 to 60.27, p=0.001), congenital anomalies (AOR=12.7, 95% CI=3.37 to 47.52, p=0.001), and multiple surgical procedures (AOR=9.7, 95% CI=2.79 to 33.54, p=0.001).ConclusionPerioperative mortality remains high in our institution.