Outcomes of neonatal surgery in a tertiary neonatal unit in Cairo : a retrospective study

Abstract EN

Background : neonatal surgery outcome is one of the parameters used for assessing the strength of healthcare systems.

despite advances in neonatal care worldwide, the differences between neonatal surgery outcomes in developed and developing countries are still huge.

aim : to retrospectively evaluate the outcome of the neonatal intensive surgery care unit, of children hospital of ain shams university during the period from 01 / 2022-06 / 2022.

patients& methods : medical records of all babies admitted to surgery NICU during the study period with a provisional surgical problem were eligible for enrollment.

only neonates with confirmed surgical problems were included in the study.

Neonates whose notes were missing key clinical were excluded.

results : eight five neonates were included, 53 (62.4%) males and 32 (37.6%) females.

twenty two were preterms (25.9%) and 63 were full terms (74.1%).

seventy-nine patients (78.8%) were managed by general neonatal surgeons and 11.2% required specialized neonatal surgery care.

seventy-six (89.4%) had surgical operations and 9 (10.6%) were managed conservatively or palliatively.

tracheooesophageal fistula (TOF) and isolated anal pathology were the most common diagnoses (12.9% & 11.7% respectively).

the overall mortality was 27% (23 / 85).

Congenital diaphragmatic hernia and TOF were both significantly correlated to mortality (p = 0.006 & 0.003 respectively).

the mortality was significantly correlated to prematurity (p = 0.001), invasive ventilation > 48 hours (p = 0.000), central line insertion during their stay (p = 0.000) and abdominal surgery (p = 0.001).

regression analysis for prediction of mortality showed that invasive ventilation was the single factor that significantly correlated to poor outcome (p = 0.009).

conclusion : our study might indicate that prematurity, git pathology, invasive ventilation > 48 hrs and insertion of central line were correlated with higher mortality.

however, further prospective studies are highly recommended to confirm their exact impact and the causation relation to neonatal outcome