NEONATAL SURGICAL OUTCOMES- THE ROLE OF SOCIOECONOMIC STATUS
Kelly - Ann Bobb,
THE UNIVERSITY OF THE WEST INDIES, St. Augustine, Trinidad and Tobago
Aim of Study:
Neonatal surgical fatalities have been classically linked to patient factors such as prematurity and low birth weight. The inverse relationship with high mortality and low socioeconomic status has been well depicted in literature. We sought to investigate whether our status as a high income country reflects on neonatal mortality.
Inclusion criteria was any patient age 0 to 28 days having a surgical procedure, excluding neurosurgical and orthopaedic procedures. Data was collected retrospectively from patient records.
One hundred and four (104) surgical procedures were performed at a single tertiary health institution, over a five (5) year period from 2011 to 2015. Of these cases, gastrointestinal pathologies requiring laparotomies comprised sixty (60%) percent of cases. Abdominal wall defects such as gastroschsis and omphalocoele repair were seventeen (17%) percent. The neonatal population comprised of a male to female ratio of 1.9 to 1.
There were thirty-two (32) deaths during the study period, giving a mortality of approximately thirty (30%) percent. The highest mortality was seen in the tracheo- oesophageal fistula group at fifty (50%) percent. Local and regional data demonstrated increase mortality with prematurity, low birth weight and lower socio economic status.
Despite our high income socioeconomic status, our overall neonatal surgical mortality rate was thirty (30%) percent, comparable to that of a low to middle income country.
Prematurity, low birth weight and decrease resource availablity caused an apparent increase in neonatal surgical mortality.
Ethics: Ethical approval was attained for this study.