Survival Status and Predictors of Mortality among Neonatal Surgical Patients in Selected Addis Ababa Public Hospitals, Ethiopia 2023/24: Multicenter Retrospective Cohort Study.
No Thumbnail Available
Date
2024-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
ntroduction: Neonatal surgery is one of the most challenging procedures globally, although
many neonatal surgical procedures are done, the mortality and morbidity remain high
particularly in low and middle-income countries. There is limited data in Ethiopia about
neonatal surgical mortality, so this study aimed to investigate the survival status and predictors
of mortality among neonatal surgical patients in Addis Ababa Public Hospitals.
Objective: To assess the survival status and predictors of mortality among neonatal surgical
patients in selected Addis Ababa public hospitals from 2021-2023.
Methods: A multi-center retrospective cohort study was done on 290 neonatal surgical patents
in three governmental hospitals in Addis Ababa selected using systematic random sampling from
January 2021- December 2023. The data were entered to Epi-data version 4.6 and transferred to
STATA version 15 for analysis. Bi-variant and Multi-variant Cox regression model was used to
analysis and determine the predictor variables. Hazard ratio with 95% confidence interval was
computed and p-value < 0.05 was considered statistically significant.
Result: From a sample of 313 patients, 290 were included for final analysis and followed for
median follow-up of 21 days. The overall mortality among neonatal surgical patients was
21.72% with an incidence rate of 0.21 cases per 100 person-day observation. Pre term
(AHR=6.36(95% CI,1.77 - 22.81), Underweight (AHR=5.47, 95% CI:1.55-19.24), Apgar score
0-3 (AHR=25.52, 95% CI:1.91-332.6), Preoperative NICU Admission (AHR=2.70, 95%
CI:1.38- 5.73), ASA class Ⅲ patients (AHR=4.95, 95% CI:1.01-24.27), and Postop NICU
admission (AHR=0.19, 95% CI:0.05-0.71) were found to be significantly associated with
mortality of neonatal surgical patients.
Conclusion: The mortality of neonatal surgical patients was high. The predictors of mortality
were pre term, underweight, preoperative and postoperative NICU admission, ASA class Ⅲ and
Apgar score ≤3. Neonates that need to be given more consideration are those who have Apgar
score ≤3, and those who are pre term and underweight.
Description
Keywords
Mortality, Neonatal Surgery, Predictors, Survival