Neonatal surgical outcomes: a prospective observational study at a Tertiary Academic Hospital in Johannesburg, South Africa
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Mar 2021 · 1 min read
In brief
In brief
This South African tertiary center study tracked 30-day outcomes for 198 neonatal surgical patients, finding necrotizing enterocolitis as the most common referral and gram-negative sepsis as the leading cause of morbidity (50.78%) and mortality (21.74%). Results emphasize infection control as critical to improving neonatal surgical survival.
Written by the GCMD Library team from the article.
Abstract
Purpose
The neonatal period is the most vulnerable period for a child. There is a paucity of data on the burden of neonatal surgical disease in our setting. The aim of this study was to describe the frequency with which index neonatal surgical conditions are seen within our setting and to document the 30-day outcome of these patients.
Methods
This was a single-centre prospective observational study in which all neonates with paediatric surgical pathology referred to the paediatric surgical unit with a corrected gestational age of 28 days were included.
Results
Necrotising enterocolitis was the most frequent reason for referral to the paediatric surgical unit (n = 68, 34.34%). Gastroschisis was the most frequent congenital anomaly referred (n = 20, 10.10%). The overall morbidity was 57.58%. Surgical complications contributed to 18.51% of morbidities. The development of gram negative nosocomial sepsis was the most frequent cause of morbidity (n = 98, 50.78%). Mortality at 30 days was 21.74% (n = 40). Sepsis contributed to mortality in 35 patients (87.5%), 16 of which had gram negative sepsis.
Conclusion
Gram-negative sepsis was a major contributing factor in the development of morbidity and mortality in our cohort. Prevention and improvement in infection control are imperative if we are to improve outcomes in our surgical neonates.