Time to Death and Predictors Among Neonates with Esophageal Atresia in Ethiopia

Moges, Natnael; Sebsbie, Girum; Adimasu, Mekonen; Getaneh, Fekadeselassie Belege; Arage, Getachew; GebreEyesus, Fisha Alebel; Bayih, Wubet Alebachew; Chanie, Ermias Sisay; Bantie, Berihun; Kerebeh, Gashaw; Birhanu, Dires; Jemere, Tadeg; Dessie, Anteneh Mengist; Kassaw, Amare

doi:10.2147/jmdh.s366470

Cited by 4 publications

(5 citation statements)

References 26 publications

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“…Neonates diagnosed as having TEF were more hazardous than those neonates who did not have. In this study, about 24.6% of neonates were died due to diagnosed TEF, which is consistent with previous study ( 40 ). Neonates with this condition potentially develop aspiration and faced feeding difficulties resulting in low calories and immunity which affect their growth and development.…”

Section: Discussionsupporting

confidence: 93%

Time to death and its predictors among neonates who were admitted to the neonatal intensive care unit at tertiary hospital, Addis Ababa, Ethiopia: Retrospective follow up study

et al. 2022

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BackgroundsNeonatal death is the major problem in developing world. Burden and predictors of neonatal mortality vary across countries and even among regions of a country, so understanding the problem concerning these factors is essential to overcome the problem. Therefore, this study aimed to determine time to death and its predictors of neonatal mortality among neonates who were admitted to the neonatal intensive care unit of Tertiary Hospital, Addis Ababa, Ethiopia.MethodsA hospital-based retrospective cohort study was employed among 434 neonates admitted in Tertiary hospital, Addis Ababa, Ethiopia. A Kaplan Meier curve and a log-rank test were used to estimate the survival time and compare survival curves between variables. The cox proportional hazard model was also fitted to identify predictors.ResultsA total of 434 neonates included in the study, 11.1% of which were died, and the incidence rate was 19.2 per 1000 live births. The time to death of neonates was 17 days. Independent predictors of neonatal mortality were incomplete maternal antenatal follow up[AHR: 3.7 (95% CI:1.86,7.60)], low(Appearance, Pulse, Grimily, Activity, and Respiration(APGAR)score[AHR:5.0 (95%CI:1.51–15.04)], perinatal asphyxia [AHR:5.2 (95%CI:1.92–14.30)], preterm 4.2 (95%CI: 1.32–8.83)]. Moreover, small for gestational age [AHR:4.8 (95%CI:2.33–9.72)], respiratory distress[AHR: 2.5 (95%CI: 1.24–5.09)], sepsis [AHR: 3.4 (95%CI: 1.71–4.01)], low birth weight[AHR: 7.3 (95%CI:2.69,1.91)], and tracheoesophageal fistula [AHR: 2.2 (95%CI: 1.13–4.32)].ConclusionThe overall incidence rate was 19.2 deaths per 1,000 live births. Emphasis should be given to incomplete Antenatal care follow up, small for gestation, preterm, low birth weight, low 5th min APGAR score, neonatal sepsis, respiratory distress, perinatal asphyxia, and tracheoesophageal fistula.

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Section: Discussionsupporting

confidence: 93%

Time to death and its predictors among neonates who were admitted to the neonatal intensive care unit at tertiary hospital, Addis Ababa, Ethiopia: Retrospective follow up study

et al. 2022

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“…The difference could be explained by the advanced surgical and medical care provided to newborns with esophageal atresia in western nations. Additionally, one factor contributing to the greater fatality rate in the TASH context may be the lack of complete parenteral nutrition (TPN) and mechanical ventilation in the NICU of TASH [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Dehydration: Neonates with EA who had signs and symptoms of dehydration and documented on the medical chart as dehydration. Sepsis: Neonates with EA who had signs and symptoms of infection and documented on the chart as sepsis [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

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Surgical outcome and predictors of neonates with esophageal atresia admitted at Tikur Anbesa Specialized Hospital

Moges,

Ahmed,

Birhanu

et al. 2023

PLoS ONE

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Background Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. This anomaly continues to cause considerable morbidity and mortality in Sub-Saharan Africa, presenting various concerns about how to treat esophageal atresia. Esophageal atresia-related neonatal mortality can be reduced by evaluating the surgical outcome and identifying associated factors. Objective This study aimed to assess the surgical outcome and identify predictors of neonates with esophageal atresia admitted at Tikur Anbesa specialized hospital. Methods Retrospective crossectional study design was employed on 212 neonates with esophageal atresia who were undergone surgical intervention in Tikur Anbesa specialized hospital. Data were entered into epi data 4.6 and exported to Stata version 16 software for further analysis. A logistic regression model with Adjusted odds ratio (AOR), confidence interval (CI) and p-value <0.05 were used to identify predictors of poor surgical outcome of neonates with esophageal atresia. Result In this study, 25% of newborns who underwent surgical intervention at TikurAbnbesa specialized hospital had successful surgical outcomes, compared to 75% of neonates with esophageal atresia who had poor surgical outcomes. Significant predictors of the poor surgical outcome of neonates with esophageal atresia were severe thrombocytopenia (AOR = 2.81(1.07–7.34)), timing of surgery (AOR = 3.7(1.34–10.1), aspiration pneumonia (AOR = 2.93(1.17–7.38)) and related abnormalities (AOR = 2.26(1.06–4.82)). Conclusion The results of this study showed that, when compared to other studies, a substantial percentage of newborn children with esophageal atresia had poor surgical outcomes. Early surgical management, aspiration pneumonia and thrombocytopenia prevention and therapy play a big part in improving the surgical prognosis for newborns with esophageal atresia.

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“…A Brazilian study showed that advanced disease and surgical complications were the most common causes of death among perioperative patients (Meara et al 2016 ). One multinational LIC study on a 7-day cohort of perioperative outcomes put forward cardiovascular complications as the leading cause of death (Misganaw et al 2022 ). Regardless, septic shock was the most predominant cause of death in the surgical population.…”

Section: Discussionmentioning

confidence: 99%

Perioperative mortality of emergency and elective surgical patients in a low-income country: a single institution experience

Degu,

Kejela,

Zeleke

2023

Perioper Med

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Background The perioperative mortality rate is an indicator of access to safe anesthesia and surgery. Studies showed higher perioperative mortality rates among low- and middle-income countries. But the specific causes and factors contributing to perioperative death have not been adequately studied in the Ethiopian context. Methods This is a retrospective institutional study of the largest academic medical center in Ethiopia. Data of all patients who were admitted to surgical wards or intensive care and underwent surgical interventions were evaluated for perioperative mortality rate determination. All mortality cases were then evaluated in depth. Results Of the 3295 patients evaluated, a total of 148 patients (4.5%) died within 30 days of surgery. By the 7th postoperative day, 69.5% of the perioperative mortality had already occurred. Septic shock contributed to 54.2% of deaths. Emergency surgery patients had more than a twofold higher mortality rate than elective surgery patients (p value < 0.001) and had a 2.6-fold higher rate of dying within 7 days of surgery (p value of 0.02). Patients with ASA performance status of 3 or more had a 1.7-fold higher rate of death within 72 h of surgery (p value of 0.015). Conclusion More than two thirds of patients died within 7 postoperative days. More emergency patients died than elective counterparts, and emergency cases had a higher rate of dying within 7 days of surgery. Poor ASA performance score was associated with earlier postoperative death. Further prospective multi-institutional studies are warranted to elucidate the factors that contribute to higher postoperative mortality in low-income country patients.

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Time to Death and Predictors Among Neonates with Esophageal Atresia in Ethiopia

Cited by 4 publications

References 26 publications

Time to death and its predictors among neonates who were admitted to the neonatal intensive care unit at tertiary hospital, Addis Ababa, Ethiopia: Retrospective follow up study

Time to death and its predictors among neonates who were admitted to the neonatal intensive care unit at tertiary hospital, Addis Ababa, Ethiopia: Retrospective follow up study

Surgical outcome and predictors of neonates with esophageal atresia admitted at Tikur Anbesa Specialized Hospital

Perioperative mortality of emergency and elective surgical patients in a low-income country: a single institution experience

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