Neonatal surgical mortality at a low resource setting, HEAL Africa tertiary hospital, Eastern Democratic Republic of the Congo
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In brief
In brief
This retrospective study examines outcomes for 107 neonates requiring surgery at a tertiary hospital in Eastern DRC over 7 years. Overall mortality was 29%, with operated patients showing significantly better survival (16.4% mortality) compared to non-operated cases, while low birth weight (<2500g) was a major risk factor for death.
- Neonatal surgical mortality was 29% overall at this low-resource DRC center, with operated patients having significantly lower mortality (16.4%).
- Myelomeningocele/meningocele was the most common surgical condition (27.1%), with 81% of patients referred from within 10 km.
- Low birth weight (<2500g) was a strong predictor of mortality (OR 5.3), highlighting vulnerability in resource-limited settings.
- Only 68% of neonates with surgical conditions underwent operation, suggesting resource constraints limited access to definitive care.
- Mean length of stay was 9.9 days, with outcomes heavily influenced by patient selection due to resource limitations.
Written by the GCMD Library team from the article.
Abstract
Purpose
This study describes the experience with common neonatal surgical conditions and their outcomes at a single center in the Eastern Democratic Republic of the Congo (DRC) over a period of 7 years (2016–2022).
Methods
A retrospective review of neonatal surgical admissions and their outcomes was performed for patient admitted between January 2016 and December 2022 at HEAL Africa teaching hospital. Data were collected from the neonatal admission and discharge registry for all patients with a potential surgical condition.
Results
107 neonates potentially requiring surgery were identified. 81.3% were referred from facilities within 10 km of HEAL Africa. The most common diagnosis was myelomeningocele/meningocele (27.1%). 68.2% of patients had an operation. The overall mortality was 29% for all patients and mean length of stay 9.9 days. Operated patients had a lower mortality at 16.4% (p-value < 0.001, OR 0.155, CI 0.062–0.389) while patients with a birth weight of less than 2500 g were more likely to die (p-value < 0.001, OR 5.333, CI 2.062–13.79).
Conclusion
The neonatal mortality rate for patients presenting with a potential surgical condition is extremely high. This is multifactorial and largely related to patient selection inherent to resource limitations.