Pediatric Anesthesia and Critical Care Journal (PACCJ) (May 2021)
Postoperative outcome in children aged between 3 and 6 years in abdominal surgery, neurosurgery and orthopedics
Abstract
Introduction Previously published studies have revealed the multifac-torial characteristics of predictors of postoperative out- come in surgical pediatric patients. We have undertaken a detailed description of these outcomes with regard to age. Objective: To describe postoperative outcomes in children aged between 3 and 6 years in children included in the initial retrospective observational study in children in neurosurgery, abdominal and orthopedic surgery. Material and Methods Secondary analysis of children between 3 and 6 years in- cluded in the initial retrospective study. The study was approved by the Ethics Committee. Results There were 72 children included with a mean age of 52.2±10.3 months. 50% of the patients (36) were ASA grade 3. 15 patients (20.8%) underwent an emergency intervention. The most common surgical interventions were intracerebral tumor resection in 11 patients (15.3%), neuroblastoma in 8 pa- tients (11.1%), scoliosis in 7 patients (9.7%), craniosynostosisin 6 patients (8.3%), intestinal resection in 5 patients (6.9%), pelvic osteotomy in 4 patients (5.6%) and exploratory laparotomy in 4 patients (5.5%). There were 20 patients (27.8%) who presented intra-op- erative and or postoperative complications. 4 patients (5.6%) had intra-operative hemorrhagic shock. The most common postoperative organ dysfunctions were respira- tory failure in 5 patients (6.9%) and cardio-circulatory failure in 3 patients (4.2%). The most common postoper- ative infections were pulmonary sepsis in 3 patients (4.2%), abdominal sepsis in 3 patients (4.2%) septicemia in 3 patients (4.2%). 6 (8.3%) patients had re-operations. 43 (59.7%) patients were transfused intra-operatively. In- hospital mortality rate was 2.8% (2 patients). Median total length of hospital stay was 10 days [4-23.5]. Conclusion 27.8% of the patients presented with intra-operative and or postoperative complications. These patients were in majority ASA grade 3, that is to say high risk patients. Predictors of postoperative outcome are multifactorial, it is time to reconsider integrating goal directed therapies in high risk patients undergoing high risk interventions to improve postoperative outcome.
Keywords
