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Retrospective study of postoperative mortality at a tertiary children's hospital in Iran: A cross sectional study
Mohammad Gharavifard1, Majid Sharifian1, Amir R Reihani2
1Mashhad University of Medical Sciences, Anesthesiology, Mashhad, Razavi Khorasan, Iran.
Insights
Post-operative pediatric mortality is higher in developing countries. This study found that patient age and surgery type significantly predict mortality in children undergoing surgery in Iran.
Area of Science:
- Pediatric Surgery
- Public Health
- Healthcare Outcomes
Background:
- Pediatric surgical mortality rates are higher in developing countries compared to developed nations.
- Limited data exists on the specific causes of post-operative death in children in these regions.
- Understanding these factors is crucial for improving pediatric postoperative care.
Purpose of the Study:
- To investigate in-hospital mortality rates in pediatric surgical patients.
- To identify the primary causes of post-operative death in children.
- To analyze factors influencing mortality at a major pediatric tertiary referral hospital in Iran.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) who underwent surgery between January 2015 and January 2018.
- Inclusion of data on patient demographics, comorbidities, surgery type, and emergency level.
- Analysis of operation length and mortality rates at different post-operative time intervals.
Main Results:
- A total of 55,027 surgeries resulted in 214 deaths, with a 30-day mortality rate of 78.6 per 10,000 procedures.
- Children under three years old had the highest mortality rate (67.2 per 10,000).
- Cardiac disease was the most common comorbidity (18.9%), and patient age and surgery type significantly correlated with the time to death.
Conclusions:
- Patient age and the type of surgery performed are the most significant predictors of post-operative mortality in pediatric patients.
- These findings highlight critical areas for targeted interventions to reduce pediatric surgical mortality.
Introduction:
Although mortality rates among children after surgery in developing countries are higher than in developed nations, little is known about the causes of post-operative pediatric death. Further insight into post-operative mortality rates and causes of death may help improve postoperative care. The present study investigates in-hospital mortality rates and causes of death at a major pediatric tertiary referral hospital in Iran.
Methods:
Patients younger than 18 years of age who underwent surgery with anesthesia between January 1, 2015 and Jan 1, 2018 at Dr. Sheikh Children's Hospital in Mashhad, Iran, were included in this retrospective study. Factors connected to the surgery and mortality rate were analyzed, including patient demographics and comorbidities, surgery type and emergency level, length of operation, and the mortality rate at different time intervals after surgery, were analyzed.
Results:
A total of 55,027 surgeries were performed between 2015 and 2018, resulting in 214 deaths. Pediatric mortality within 30 days was 78.6 deaths per 10,000 procedures. The highest mortality rate was observed in children under three years of age (67.2 per 10,000), and females were more likely than males to die after an operation (52.8%). The most common comorbidity associated with postoperative death was cardiac disease(18.9%). There was a significant relationship between age and time interval between surgery and death showed (p < 0.0001), and type of surgery (p = 0.013) with the time interval between surgery and death.
Conclusion:
This study demonstrated that patient age and type of surgery were the main predictors of post-operative mortality.
Study Type:
Prognosis study.
Level Of Evidence:
Level II.
