A 10-year retrospective review of perioperative mortality in pediatric general surgery at Ile-Ife Hospital, Nigeria

Background/Purpose: The analysis of perioperative mortality as well as surgery- and anesthesia-related death in pediatric patients may serve as a potential tool to improve outcome. The aim of this study is to report the 24-h and 30-day overall, and surgery and anesthesia-related, mortality in a tertiary hospital. Methods: This is a retrospective review of perioperative mortality in children ≤ 15 years at a general pediatric surgery unit. All pediatric general surgery cases operated under general anesthesia between January 2007 and December 2016 were included in the study and data analyzed. Results: A total of 4108 surgical procedures were performed in 4040 patients. The age was 1 day to 15 years with a median age of 2 years. The all cause 24-h mortality was 34 per 10,000 procedures and the all cause 30-day mortality was 156 per 10,000 procedures. Septicemia was the most common cause of death. The determinants of mortality were neonatal age group (Adjusted Odd Ratio (AOR) = 0.033, 95% CI = 0.015–0.070, p = 0.001), emergency surgery (AOR = 90.91, 95% CI = 27.78–333.33, p = 0.001), higher ASA status (AOR = 0.014, 95% CI = 0.005–0.041, p = 0.001) and multiple operative procedures (AOR = 38.46, 95% CI = 10.64–142.85, p = 0.001). Conclusions: Neonatal age group, children with poorer ASA status, emergency and multiple surgeries were predictors of perioperative mortality. Level of evidence: Retrospective study.