Predictors of postoperative mortality among neonates after major-risk surgery: A one-year experience from a Tunisian hospital

Authors

  • Manel Kammoun Hedi Chaker University Hospital, University of Sfax, Tunisia
  • Anouar jarraya Hedi Chaker University Hospital, University of Sfax, Tunisia
  • Hechem bradai Hedi Chaker University Hospital, University of Sfax, Tunisia
  • Hind ketata Hedi Chaker University Hospital, University of Sfax, Tunisia
  • Hasna Bouchaira Hedi Chaker University Hospital, University of Sfax, Tunisia
  • Olfa Cherif Hedi Chaker University Hospital, University of Sfax, Tunisia
  • Amel Ben Hamed Hedi Chaker Hospital,Sfax, Tunisia
  • Faiza Safi Hedi Chaker Hospital, Sfax, Tunisia
  • Riadh Mhiri Hedi Chaker Hospital, Sfax, Tunisia

DOI:

https://doi.org/10.47338/jns.v13.1275

Keywords:

Anesthesia, Neonatal mortality, Predictors, Neonatal surgery, Perioperative management

Abstract

Background: Neonatal surgery in developing countries remains a high-risk modality p and its outcomes depend on various patient-related, system-related, and management-related factors. This study aims to describe our experience in managing newborns requiring surgical interventions and to investigate the primary predictors of postoperative mortality.

Methods: In this observational study, we included all newborns aged less than 28 days who underwent surgery in the pediatric surgery department under general anesthesia with tracheal intubation for major-risk surgery. Patients were categorized into two groups based on the outcome (survival or death) during the two months following surgery. Following a comparison of the two groups, univariable and multivariable logistic regression analyses were conducted to explore predictors of perioperative mortality among neonates.

Results: Sixty-seven newborns were included in this study, with an early mortality incidence of 28.3%. Anesthesia management did not impact neonatal mortality. The main predictors of neonatal mortality were revision surgery [aOR=35.5; 95% CI: 1.33- 94.1], surgery duration ≥ 120 minutes [aOR=36.5; 95% CI: 1.48- 312], preoperative mechanical ventilation [aOR=3.88; 95% CI: 1.12- 30.8], and the occurrence of perioperative adverse events [aOR=5.7; 95% CI: 1–29.5] or postoperative surgical complications [aOR=32.5; 95% CI: 1.05–101].

Conclusion: The early mortality rate after major neonatal surgery remains high in our department. It appears that preoperative poor conditions can elevate the risk. Additionally, major-risk surgeries requiring prolonged procedures and revision surgery, along with the incidence of postoperative infections, significantly increase the risk of neonatal mortality.

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Author Biographies

Manel Kammoun, Hedi Chaker University Hospital, University of Sfax, Tunisia

Pediatric Anesthesia Department,

Anouar jarraya, Hedi Chaker University Hospital, University of Sfax, Tunisia

Pediatric Anesthesia Department,

Hechem bradai, Hedi Chaker University Hospital, University of Sfax, Tunisia

Pediatric Anesthesia Department,

Hind ketata, Hedi Chaker University Hospital, University of Sfax, Tunisia

Pediatric Anesthesia Department,

Hasna Bouchaira, Hedi Chaker University Hospital, University of Sfax, Tunisia

Pediatric Anesthesia Department,

Olfa Cherif, Hedi Chaker University Hospital, University of Sfax, Tunisia

Pediatric Anesthesia Department,

Amel Ben Hamed, Hedi Chaker Hospital,Sfax, Tunisia

Neonatal Intensive Care Department,

Faiza Safi, Hedi Chaker Hospital, Sfax, Tunisia

Pediatric Intensive Care Department,

Riadh Mhiri, Hedi Chaker Hospital, Sfax, Tunisia

Pediatric Surgery Department,

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Published

2023-12-31

How to Cite

1.
Kammoun M, jarraya A, bradai H, ketata H, Bouchaira H, Cherif O, Ben Hamed A, Safi F, Mhiri R. Predictors of postoperative mortality among neonates after major-risk surgery: A one-year experience from a Tunisian hospital. J Neonatal Surg [Internet]. 2023Dec.31 [cited 2024Jul.21];13:10. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/1275

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