Predictive value of the National Surgical Quality Improvement Program - Pediatrics risk calculator in neonatal patients. A retrospective correlational study.

OBJECTIVE: To verify the predictive value of the American College of Surgeons National Surgical Quality Improvement Program-Pediatric calculator as a prognosis for complications in neonatal patients undergoing surgery. METHOD: An observational, retrospective, cross-sectional and correlational study was carried out. The files of the surgical neonates of the neonatology unit of the General Hospital of Puebla Dr. Eduardo Vázquez Navarro in the period between January 2014 and May 2017. The data was emptied into the platform yielding percentages of risk estimation. The patients were followed up through the files observing their evolution to determine which complications developed. The data obtained in the platform was correlated with the data obtained in the file and the predictive value of the scale was determined. RESULTS: According to the classification of presence or absence of complication, they stand out for correlations without statistical significance. Presenting positive correlation in 78 cases (10.19%), negative correlation in 279 cases (36.47%) and null correlation in 408 cases (53.34%). CONCLUSION: It was shown that the scale has a low predictive value with a tendency to overestimate, however, its usefulness was corroborated as part of the informed consent process in surgical neonates.

OBJETIVO: Comprobar el valor predictivo del calculador American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) como pronóstico de complicaciones en pacientes neonatos sometidos a cirugía. MÉTODO: Se realizó un estudio observacional, retrospectivo, transversal y correlacional. Se recopilaron los expedientes de los neonatos quirúrgicos de la unidad de neonatología del Hospital General de Puebla Dr. Eduardo Vázquez Navarro en el periodo comprendido entre enero de 2014 y mayo de 2017. Los datos se vaciaron en la plataforma arrojando porcentajes de estimación de riesgo. Se dio seguimiento a los pacientes por medio de los expedientes, observando su evolución para determinar qué complicaciones desarrollaron. Se correlacionaron los datos obtenidos en la plataforma con los hallados en el expediente y se determinó el valor predictivo de la escala. RESULTADOS: De acuerdo con la clasificación de presencia o no de complicación, destacan por correlaciones sin significancia estadística. Presentan correlación positiva 78 casos (10.19%), correlación negativa 279 casos (36.47%) y correlación nula 408 casos (53.34%). CONCLUSIÓN: Se demostró que la escala tiene un bajo valor predictivo con tendencia a la sobrestimación; sin embargo, se corroboró su utilidad como parte del proceso de consentimiento informado en los neonatos quirúrgicos.

Neonatal Intestinal Obstruction Syndrome.

Neonatal intestinal obstruction is caused by an anatomical abnormality that produces bowel movement failure. Intestinal obstruction presents with three classic clinical signs: vomiting, abdominal distention, and failure to pass meconium. Intestinal obstruction is one of the most common causes for admitting a pediatric patient to the pediatric surgery unit in his or her first weeks of postnatal life. Congenital obstruction of the digestive tract in neonates is a common problem, with the most frequent cause being anorectal malformations (41%), followed by esophageal obstruction (24%), and duodenal obstruction (20%). [Pediatr Ann. 2018;47(5):e220-e225.].