Perioperative mortality in children in a tertiary teaching hospital in Nigeria: a prospective study

Area of Science:

• Pediatric Surgery
• Healthcare Quality Assessment
• Public Health

Background:

• Perioperative mortality serves as a critical indicator of healthcare delivery effectiveness.
• Auditing mortality rates is essential for evaluating national healthcare standards.
• This study focuses on pediatric surgical patients to assess perioperative outcomes.

Purpose of the Study:

• To determine 24-hour, 7-day, and 30-day perioperative mortality rates in a pediatric surgical cohort.
• To identify significant predictors of mortality within this patient group.
• To provide data for improving perioperative care in pediatric surgery.

Main Methods:

• A prospective study was conducted on 502 children (aged hours to 15 years) undergoing 530 surgical procedures.
• Data were collected between May 2019 and April 2020.
• The primary outcome measured was in-hospital perioperative mortality.

Main Results:

• The 24-hour, 7-day, and 30-day mortality rates were 113.2, 207.6, and 320.8 per 10,000 procedures, respectively.
• Congenital anomalies, particularly when complicated by postoperative sepsis, were a major cause of death.
• Predictors of mortality included neonatal age, American Society of Anesthesiologists Physical Status III or higher, emergency surgery, congenital anomalies, and multiple procedures.

Conclusions:

• Perioperative mortality rates in the studied pediatric surgical cohort remain high.
• Identifying specific risk factors is crucial for targeted interventions and improved patient outcomes.
• Continuous monitoring and quality improvement initiatives are necessary in pediatric surgical care.