Retrospective analysis of pattern and outcome of neonatal surgical cases at Tikur Anbesa university teaching hospital, Addis Ababa, Ethiopia

ABSTRACT

Back ground/ Purpose:The survival of neonates with surgical condition has greatly improved in developed countries but still poor in developing countries due to several challenges with neonates requiring surgical care. The aim of this study is to determine major causes of surgical neonatal admissions and their immediate outcome.Materials and Methods: A retrospective review of medical records of surgical neonates who were admitted and treated at Tikur Anbesa Hospital between January 1st 2010 and December 31st 2014.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 with MF ratio of 1.61. Majority of the cases (86.2%) were having congenital diagnoses. Lesions of the gastrointestinal tract (43.3%) mainly anorectal malformations followed by abdominal wall defects (15.5%) were the major pathologies. Two-third of the cases (66.6%) underwent surgical management. The overall hospital mortality following admission was 24.4%. Case fatality rate ranging from 0.03% forHirschsprung's disease to 73.2% for esophageal atresia with or without fistula. The immediate causes of death among these neonates were ascribed to septic shock and respiratory failure. Conclusion:Neonatal surgical admission is common in our institution.Overall mortality after neonatal surgical admission was quite high. Type of principal diagnosis and age of the neonate at admission significantly associated with outcome.Creating awareness about neonatal surgical condition may help to improve the current poor result: