Burden and spectrum of neonatal surgical diseases in a tertiary hospital: a decade experience

Abstract

Background: Surgical emergencies in the newborns are an important and integral part of neonatal admissions in any tertiary Neonatal intensive care units. Surgical emergencies in the newborn constitute congenital anomalies and acquired neonatal emergencies. It is necessary to know the burden of these illnesses and their spectrum by regular auditing the data available to understand the relative incidence and outcome of these neonatal emergencies. Aims and objective of the study is to determine the spectrum of the different neonatal surgical emergencies (congenital and acquired) admitted, operated and managed in a tertiary NICU from June 2001 to May 2011(10 yrs) in a medical college teaching hospital in South IndiaMethods: The data was collected by retrospectively auditing the hospital pediatric and neonatal admission registry, neonatal surgical registry, admission case sheets from June 2001 to June 2011 (10 yrs). Data was analysed. Only confirmed post-operative surgical diagnosis were considered for inclusion in the study.Results: Of the 13,118 newborns admitted in the NICU in 10 years, 601 cases (4.6%) were surgical neonates which were treated in the unit. 83.5% of surgical neonates were operated for congenital surgical disorders. Gastrointestinal anomalies (50%) were the leading causes of neonatal surgical emergencies. Anorectal malformations (18.5%), idiopathic hypertrophic pyloric stenosis (10.6%) and esophageal atresia with/without tracheo-esophageal fistula (8.7%) were the leading surgical causes which needed immediate surgical intervention in the newborn period. 28 different spectrum of cases were operated including 15 rarer once (<1% incidence each).Conclusions: Surgical new-borns comprises of an important and integral part of neonatal admissions (4.6/100 neonatal admissions). The incidence of the rarer diseases constitutes 8% of the total surgical cases. Gastrointestinal anomalies are the leading causes requiring surgical interventions in the immediate newborn period. It is worthy to understand the spectrum of illnesses in any tertiary unit by regularly auditing the data available.

Disease spectrum analysis of hospitalized children in China: A study of 18 tertiary children's hospitals

“…Previous disease spectrum studies of children were mostly based on a single center or department, and the data were therefore less nationally representative. This study included 18 tertiary children's hospitals, nearly one‐third of all tertiary children's hospitals in China, and covered main cities in both the north and south of the country, so the data can be considered more comprehensive and the results more representative.…”

The Outcome of Different Surgical Conditions in Neonates at A Tertiary Care Hospital: A Cross-Sectional Study

“…3 The mortality associated with neonatal surgical conditions range from 21-45% in developing countries and is <15% in European countries. 14 The mortality rate of surgical neonates at our department in spite of limited resources is on the lower side as compared with other studies conducted in resource-poor setup. 13,14 This may be a discrete clinical entity from NEC in preterm newborns, according to a study's conclusion that neonates present with different illness patterns and experience different outcomes.…”

“…14 The mortality rate of surgical neonates at our department in spite of limited resources is on the lower side as compared with other studies conducted in resource-poor setup. 13,14 This may be a discrete clinical entity from NEC in preterm newborns, according to a study's conclusion that neonates present with different illness patterns and experience different outcomes. 15 In gastroschisis, clinical traits can be utilised to separate survivors from non-survivors.…”

Role of Thrombophilia in Neonatal Thrombosis as A Risk Factor

“…Incidence of neonatal thrombosis in our study was 34%. A study conducted in tertiary NICU from June 2001 to May 2011 (10 years) in Medical College Teaching Hospital in South India showed matched results that thrombophilic newborn were 4.6% of neonatal admissions (12) . As well Ugwu and Okoro (13) reported that the incidence of neonatal thrombosis was 6.2%.…”

“…Increased surgical problems admissions in our study explained by availability of neonatal surgical unit in our hospital that considered as a referral unit for neonatal surgical problems. A study conducted in a tertiary NICU from June 2001 to May 2011 (10 yrs) in a medical college teaching hospital in South India, showed matched results that surgical newborns were 4.6% of neonatal admissions and GIT anomalies are the most important causes necessitating surgical interventions in the immediate newborn period (12) . As well as Ugwu and Okoro (13) reported that the incidence of neonatal surgical problems was 6.2% and congenital anomalies were more than 80% of all neonatal surgical diseases and the most frequent surgical problems in the neonates involve GIT.…”