A. Ranjit2, R. Shrestha1, A. Prasad3, K. P. Devkota1, R. Kulshrestha3 1Nepal Medical College And Teaching Hospital,Surgery,Kathmandu, BAGMATI, Nepal 2Brigham And Women’s Hospital,Center For Surgery And Public Health,Boston, MA, USA 3Sir Ganga Ram Hospital,Pediatric Surgery,Delhi, NEW DELHI, India
Introduction:
Low and Middle-Income countries (LMIC) bear the majority of the global pediatric surgical burden. Despite increasing volumes of pediatric surgery being performed in LMIC, outcomes of these surgeries in LMIC remains unknown due to lack of robust data. To that end, the objective of our study was to collect data on and evaluate neonatal surgical outcomes at a tertiary level center in India.
Methods:
The surgical outcomes data of all neonates undergoing major surgical procedure between February 1, 2015 and December 31, 2015, at Sir Ganga Ram Hospital, a tertiary level center in New Delhi, India was collected prospectively. Patient demographics, preoperative clinical characteristics and postoperative outcomes including surgical site infection (SSI), sepsis, length of stay (LOS), number of ventilator days and in-hospital mortality were recorded. Descriptive statistics were used to determine the rates of various postoperative outcomes.
Results:
A total of 37 neonatal surgeries were performed during the study period. The mean age of the neonates on the day of surgery was 7 days (range: 1-30 days). Most of the neonates (72.9%, n=27) were males. About 40% (n=15) of the neonates were preterm and 15 (40.5%) of them were small for gestational age. The average LOS was 22 days (range: 2-80 days). In our study,10 neonates (28.6%) needed ventilation for 48 hours or less after surgery and 5 neonates (13.5%) were kept postoperative Nil per Oral (NPO) for more than 10 days. Out of 37 neonates, 4 (10.80%) developed a surgical site infection and 8 neonates (21.6%) had postoperative sepsis. The in-hospital mortality rate among neonates undergoing a surgical procedure during the study period was 8.1 deaths per 100 neonates.
Conclusion:
Our study demonstrates the feasibility of data collection to study neonatal surgical outcomes in low and middle-income countries and might help encourage other centers in LMIC to conduct pediatric surgical outcome research.