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Pediatric Perioperative Mortality in Southeastern (SE) Nigeria-A Multicenter, Prospective Study
E P Nwankwo1, D C Onyejesi1, I S Chukwu2
1Department of Pediatric Surgery, College of Medicine, University of Nigeria Nsukka, Enugu State, Nigeria.
Nigerian Journal of Clinical Practice
|May 6, 2025
Summary
The pediatric perioperative mortality rate in Southeastern Nigeria is high, particularly for gastroschisis. Key predictors of mortality include comorbidities, higher ASA status, and sedation without ventilatory support.
Area of Science:
- Pediatric Surgery
- Public Health
- Surgical Quality Improvement
Background:
- Perioperative mortality rate is a critical metric for surgical quality in low and middle-income countries (LMICs).
- Assessing pediatric surgical outcomes is vital for targeted interventions.
Purpose of the Study:
- To determine the perioperative mortality rate for pediatric surgical conditions in Southeastern Nigeria.
- To identify significant predictive factors for mortality in this population.
Main Methods:
- Prospective, multicenter study conducted over nine months in five tertiary hospitals.
- Inclusion criteria: children under 18 years undergoing anesthesia or surgery.
- Data collected on all-cause and case-specific in-hospital perioperative mortality rates and predictive factors.
Main Results:
- A total of 775 patients were included, with 28 deaths, resulting in a 30-day perioperative mortality rate of 3.61%.
- Gastroschisis and ruptured omphalocele had a 100% mortality rate, with sepsis as the primary cause (53.6%).
- Significant mortality predictors included higher American Society of Anesthesiologists (ASA) status, sedation without ventilatory support, and associated comorbidities.
Conclusions:
- The pediatric perioperative mortality rate in Southeastern Nigeria is notably high, especially for gastroschisis.
- Associated comorbidities, higher ASA status, and lack of ventilatory support during sedation are significant predictors of mortality.
- Findings highlight the need for improved perioperative care and resource allocation for pediatric surgical patients in the region.
