Thirty day mortality after neonatal laparotomy in a Chinese tertiary hospital

Abstract

Background No data are available on the prevalence of mortality in neonates after major surgery such as laparotomy in China. Methods In a tertiary general hospital, 142 newborns who underwent laparotomy for a variety of surgical conditions in the past 6 years were included in this study in Beijing, China. Pre‐, intra‐, and postoperative variables potentially predictive of postoperative 30 day mortality were collected and compared between the surviving and deceased newborns. Results Death ≤30 days after laparotomy occurred in 19 of 142 newborns (13.4%) during the study period. Newborns diagnosed with necrotizing enterocolitis (NEC) had the worst outcome (OR, 11.4). Significantly more neonates in the 30 day death group were intubated preoperatively (52.6%) compared with the survival group (19.5%; OR, 10.0). Base excess ≤−10 mmol/L immediately after laparotomy was associated with negative prognosis in the early postoperative period (OR, 11.2). Conclusion The mortality rate of newborns ≤30 days after laparotomy was 13.4% in a Chinese tertiary general hospital in the past 6 years. The factors associated with early death were NEC, preoperative intubation with mechanical ventilation, and postoperative immediate base excess ≤−10 mmol/L.