Clinical Epidemiology of Paediatric Surgical Admissions and Mortality – A Single Centre Retrospective Study Over last 15 Years
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2018, Vol 3, Issue 4
Abstract
Introduction: In developing countries, surgical diseases accounts for a major cause of neonatal mortality. Study aimed to evaluate the spectrum of paediatric surgical admissions with a comparative analysis of outcome with special reference to neonates during the time period from January 1997 to December 2011. Material and Methods A retrospective analysis was conducted for children aged 12 years and below who were admitted during the period from 1997 to 2011. The number of admissions was grouped in 10 diagnostic categories and incidence and mortality in each category was evaluated. Mortality data were further analyzed and presented using mortality rate, proportional mortality rate and case fatality rate. Results of the study were projected with a comparison to results of similar studies in the different parts of the world. Results: During the 15 year period, a total of 18,721 patients were admitted into the paediatric surgery division of the Department of Surgery, M.Y.Hospital Indore. The majority of patients fell into three major diagnostic categories— Gastrointestinal (31%), Trauma (19%), and Urogenital (14%). The most common diagnosis with which neonates presented turned out to be Anorectal Malformations (25%), oesophageal atresia with or without tracheoesophageal fistla (21%) being the second most common. As a single diagnosis, over last 15 years, gastrointestinal diseases were the leading cause of surgical deaths (avg.PMR 55%). TOF is the leading cause in the GI category accounting for 25% of the deaths. Gastroschisis being the most fatal disease with an average CFR of 78%. Incidence of Anorectal malformations and tracheoesophageal fistula was higher in this part of the country in comparison to other parts of the world. Conclusion: Prenatal counselling should be an essential component of paediatric surgical practice and should be ensured in the training programme for future paediatric surgeons. Early recognition, risk stratification of the baby and timely referral to higher paediatric surgery units is the way forward to achieve parity with the international standards.
Authors and Affiliations
Mahesh Vishwakarma, Brajesh Lahoti, Ashok laddha
Keywords
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- EP ID EP472516
- DOI 10.21276/ijcmsr.2018.3.4.28
- Views 128
- Downloads 0
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