Prognostic factors for mortality in patients with congenital duodenal obstruction at DR. Moewardi Hospital Surakarta

Abstract

Background: Congenital duodenal obstruction is the most common congenital abnormalities in newborn. Almost 50% of all cases of congential abnormalities is duodenal obstruction. Several conditions of congenital obstruction can worsen a patient's prognosis, such as prematurity, low birth weight (LBW), other congenital abnormalities, type of obstruction, and the type of surgery performed. Objective: To identify prognostic factors for mortality in patients with congenital duodenal obstruction in Dr. Moewardi Hospital Surakarta. Methods: This study was a retrospective descriptive study with cross-sectional approach. Data of congenital duodenal obstruction patients were taken from inpatient medical records from January 2019 to December 2020 at Dr. Moewardi Hospital, Surakarta. Diagnosis, gestational age, birth weight, type of obstruction, other congenital abnormalities, and surgical procedure performed were also recorded. The data were then processed using SPSS 25.0, and one-way Fisher's Exact test was performed. Results: From 20 samples of patients with congenital duodenal obstruction, most of them were born at term pregnancy were 13 patients (65%). There were 11 (55%) babies who died. Based on the type of obstruction, total obstruction type were 12 (60%) patients with mortality rate 81.8%. 13 patients (65%) had comorbid congenital abnormalities. The most commonly performed surgical procedure was duodenojejunostomy (45%). Fisher's Exact test also showed statistically significant data (P = 0.04). Conclusion: There were 20 samples with congenital duodenal obstruction. The total obstruction type had the highest mortality rate. Other variables such as gestational age, birth weight, and other congenital abnormalities did not significantly influence mortality in this study.

Coagulation Parameters as a Prognostic Factor for Mortality in a Neonate with Duodenal Obstruction

“…Estiarla found that 60% of the samples were of the total obstruction type, and as many as 55% of patients with duodenal obstruction died. 15 Brantberg et al conducted a study with 29 newborns with duodenal obstruction, in which 18 (62%) died (prenatal or postnatal) or had substantial developmental impairments. A total of 10 of the 21 children alive (48%) had substantial developmental disabilities.…”

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“…Risk factors linked to mortality encompass complex cardiac abnormalities, preterm birth, sepsis, pneumonia, and surgical complications like short bowel syndrome, leaky anastomosis, and gastroduodenal dysfunction. Notably, almost 80% of mortality cases are attributed to multiple congenital abnormalities and sepsis [7]. Mortality frequently results from delayed treatment and postoperative complications.…”