Major Abdominal Surgery, Neurosurgery, Orthopedic Surgery in Children aged between 10 and 18 Years and Postoperative Outcome| Stephy Publishers

 


Stephy Publishers:  SOJ Pediatrics and Clinical Neonatology (SOJPCN)


Abstract
Background: In a previously conducted monocentric retrospective study, predictors of postoperative outcome in children included American Society of Anesthesiologists score, transfusion, emergency interventions, surgery and age. A study has been undertaken to describe postoperative outcome in patients aged between 10 and 18 years included in the initial study in abdominal surgery, neurosurgery and orthopedics.
Aims: To describe postoperative outcome in children aged between 10 and 18 years.
Methods: Secondary analysis of postoperative outcome in children aged between 10 and 18 years included retrospectively in the initial study of 594 patients. The study was approved by the Ethics Committee.
Results: There were 221 children with a mean age of 165.5±24.3 months in abdominal surgery, neurosurgery and orthopedics. 16.3% patients had intra-operative or postoperative complications. Intra-operatively, 3.2% had hemorrhagic shock, 0.45% anaphylaxis and 0.45% respiratory failure. Postoperatively, 3.2% had neurologic failure, 2.3% respiratory failure, 0.45% cardio-circulatory failure, 0.45% endocrinal failure, 0.45% had hepatic failure, 0.45% multiple organ failure, and 0.45% had renal failure. In-hospital mortality rate was 0.45%.
Conclusion: These results emphasize the importance of optimizing intra-operative management in critically ill patients in major surgery with goal directed therapies in order to improve postoperative outcome.


Keywords: Children, Abdominal surgery, Neurosurgery, Orthopedics, Outcome

 

Keynotes: Postoperative outcome is multifactorial in surgical patients. Intra-operative goal directed fluid and hemodynamic therapy to optimize patient management with validated tools in children is one of the main aims of goal directed therapies which have the objective to improve postoperative outcome in surgical patients. It is time to integrate goal directed therapies in our routine practice for intra-operative management to improve postoperative outcome in children.


Introduction
A monocentric retrospective study was conducted in 594 patients with a mean age of 90.86±71.80 months with the objective to determine predictors of postoperative outcome in abdominal surgery, neurosurgery and orthopedics.1 Postoperative outcome predictors in this study were American Society of Anesthesiologists status (ASA), transfusion, emergency, surgery and age. A similar analysis in different surgical settings was undertaken and conducted to the same conclusions.2-4 Postoperative outcome was defined as organ failure, infections, re-operations, length of stay in the intensive care unit, length of hospital stay, total length of hospital stay and length of mechanical ventilation.


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