PATTERN AND OUTCOME OF NEONATAL SURGICAL CASES AT TIKUR ANBESSA UNIVERSITY TEACHING HOSPITAL, ADDIS ABABA, ETHIOPIA.

Abstract

Introduction: The survival of neonates with surgical conditions has greatly improved in developed countries, but still remains poor in developing countries. Available evidence suggests that this is due to several challenges encountered in neonates requiring surgical care. The aim of this study was to determine causes and outcomes of neonatal surgical admissions.

Patients and methods: retrospective review of medical records of neonates who were admitted and treated at Tikur Anbessa Hospital between January1, 2010 and December 31, 2014. Data were analyzed using descriptive statistics and association between variables measured using regression analysis on SPSS version 16 statistical software.

Results: There were a total of 652 surgical neonatal admissions during the study period of which 396 were males, 252 females and 4 with indeterminate genitalia. The male to female ratio was 1.6:1. Majority of the cases 562 (86.2%) had congenital malformation. Lesions of the gastrointestinal tract 282(43.3%), mainly Anorectal malformations followed by abdominal wall defects. Two-third (66.6%) of the cases were surgically managed. Nearly onequarter of them died. The proportion who died ranged from 0.03% for Hirschsprung’s disease to 73.2% for esophageal atresia. The immediate causes of death among these series of neonates were ascribed to septic shock and respiratory failure.

Conclusion: Neonatal surgical admission is common in the Hospital. The overall number of deaths in this series of neonatal surgical cases was high. The type of principal diagnosis and the age of the neonates at admission were significantly associated with outcome. Creating awareness about neonatal surgical conditions may help to improve the current poor result.