Talabi Ademola Olusegun, Sowande Oludayo Adedapo, Adenekan Anthony Taiwo, Adejuyigbe Olusanya, Adumah Collins Chijioke, Igwe Arua Obasi
Department Of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile - Ife, Osun State, Nigeria.
Department Of Anaesthesia And Intensive Care, Obafemi Awolowo University Teaching Hospitals Complex, Ileife, Osun State, Nigeria.
J Pediatr Surg. 2018 Oct;53(10):2072-2076. doi: 10.1016/j.jpedsurg.2018.03.005. Epub 2018 Mar 10.
BACKGROUND/PURPOSE: The analysis of perioperative mortality as well as surgery- and anesthesia-related death in pediatric patients may serve as a potential tool to improve outcome. The aim of this study is to report the 24-h and 30-day overall, and surgery and anesthesia-related, mortality in a tertiary hospital.
This is a retrospective review of perioperative mortality in children ≤15years at a general pediatric surgery unit. All pediatric general surgery cases operated under general anesthesia between January 2007 and December 2016 were included in the study and data analyzed.
A total of 4108 surgical procedures were performed in 4040 patients. The age was 1day to 15years with a median age of 2years. The all cause 24-h mortality was 34 per 10,000 procedures and the all cause 30-day mortality was 156 per 10,000 procedures. Septicemia was the most common cause of death. The determinants of mortality were neonatal age group (Adjusted Odd Ratio (AOR)=0.033, 95% CI=0.015-0.070, p=0.001), emergency surgery (AOR=90.91, 95% CI=27.78-333.33, p=0.001), higher ASA status (AOR=0.014, 95% CI=0.005-0.041, p=0.001) and multiple operative procedures (AOR=38.46, 95% CI=10.64-142.85, p=0.001).
Neonatal age group, children with poorer ASA status, emergency and multiple surgeries were predictors of perioperative mortality.
Retrospective study.
背景/目的：分析儿科患者围手术期死亡率以及与手术和麻醉相关的死亡情况，可能是改善治疗结果的一种潜在工具。本研究的目的是报告一家三级医院中24小时和30天的总体死亡率以及与手术和麻醉相关的死亡率。
这是一项对一家普通儿科手术科室15岁及以下儿童围手术期死亡率的回顾性研究。纳入了2007年1月至2016年12月期间在全身麻醉下进行的所有儿科普通外科手术病例，并对数据进行分析。
共对4040例患者进行了4108例外科手术。年龄为1天至15岁，中位年龄为2岁。全因24小时死亡率为每10000例手术34例，全因30天死亡率为每10000例手术156例。败血症是最常见的死亡原因。死亡率的决定因素包括新生儿年龄组（调整后比值比（AOR）=0.033，95%置信区间=0.015-0.070，p=0.001）、急诊手术（AOR=90.91，95%置信区间=27.78-333.33，p=0.001）、较高的美国麻醉医师协会（ASA）分级（AOR=0.014，95%置信区间=0.005-0.041，p=0.001）和多次手术（AOR=38.46，95%置信区间=10.64-142.85，p=0.001）。
新生儿年龄组、ASA分级较差的儿童、急诊手术和多次手术是围手术期死亡率的预测因素。
回顾性研究。
