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Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality

Background The surgical infant requires care in specialized neonatal units. Very low birth weight (VLBW) infants are a group particularly vulnerable to the risks and outcomes associated with preterm birth. There is an increased number of abdominal emergencies seen, attributed to improved survival in...

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Main Author: Allie, Nazneen
Other Authors: Joolay, Yaseen
Format: Thesis
Language:English
Published: Department of Paediatrics and Child Health 2021
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access_status_str Open Access
author Allie, Nazneen
author2 Joolay, Yaseen
author_browse Allie, Nazneen
Joolay, Yaseen
author_facet Joolay, Yaseen
Allie, Nazneen
author_sort Allie, Nazneen
collection Thesis
description Background The surgical infant requires care in specialized neonatal units. Very low birth weight (VLBW) infants are a group particularly vulnerable to the risks and outcomes associated with preterm birth. There is an increased number of abdominal emergencies seen, attributed to improved survival in this birthweight category. Objectives To describe the short-term survival to discharge in VLBW infants following abdominal surgery at a South African public tertiary hospital and to examine the utility of common scoring systems for prognostication. Methods A retrospective study of VLBW infants with abdominal surgery was conducted in patients admitted to the neonatal unit at Groote Schuur Hospital between 2012 and 2016. CRIB and SNAPPE scores were calculated for patients where sufficient data was available. Results Fifty-two patients were included. The mean gestational age (GA) and birthweight (BW) were 29.5 weeks (SD 2.1) and 1102g (SD 197.8) respectively. Necrotizing enterocolitis was the most common (50%) surgical emergency. The leading postoperative complication was sepsis (37%). Fourty-two (81%) infants survived to discharge, the mean age at presentation 21 days (SD 21.1) with a mean hospital stay of 74 days in survivors vs 52 days in the non-survivors (p=0.06). There was no statistically significant difference in SNAPPE scores between survivors and non-survivors. Conclusion Abdominal emergencies have a high mortality and adds to the overall length of stay in VLBW infants. Neonatal scoring systems have proven to be useful adjuncts in predicting neonatal mortality, further study is warranted in infants who deteriorate due to surgical abdominal complications.
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2021
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spelling oai:open.uct.ac.za:11427/33439 Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality Allie, Nazneen Joolay, Yaseen Paediatric Medicine Background The surgical infant requires care in specialized neonatal units. Very low birth weight (VLBW) infants are a group particularly vulnerable to the risks and outcomes associated with preterm birth. There is an increased number of abdominal emergencies seen, attributed to improved survival in this birthweight category. Objectives To describe the short-term survival to discharge in VLBW infants following abdominal surgery at a South African public tertiary hospital and to examine the utility of common scoring systems for prognostication. Methods A retrospective study of VLBW infants with abdominal surgery was conducted in patients admitted to the neonatal unit at Groote Schuur Hospital between 2012 and 2016. CRIB and SNAPPE scores were calculated for patients where sufficient data was available. Results Fifty-two patients were included. The mean gestational age (GA) and birthweight (BW) were 29.5 weeks (SD 2.1) and 1102g (SD 197.8) respectively. Necrotizing enterocolitis was the most common (50%) surgical emergency. The leading postoperative complication was sepsis (37%). Fourty-two (81%) infants survived to discharge, the mean age at presentation 21 days (SD 21.1) with a mean hospital stay of 74 days in survivors vs 52 days in the non-survivors (p=0.06). There was no statistically significant difference in SNAPPE scores between survivors and non-survivors. Conclusion Abdominal emergencies have a high mortality and adds to the overall length of stay in VLBW infants. Neonatal scoring systems have proven to be useful adjuncts in predicting neonatal mortality, further study is warranted in infants who deteriorate due to surgical abdominal complications. 2021-07-07T10:58:08Z 2021-07-07T10:58:08Z 2021 2021-07-07T08:08:04Z Master Thesis Masters MMed http://hdl.handle.net/11427/33439 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences
spellingShingle Paediatric Medicine
Allie, Nazneen
Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality
thesis_degree_str Master's
title Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality
title_full Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality
title_fullStr Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality
title_full_unstemmed Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality
title_short Abdominal surgery in very low birth weight neonates in a developing world neonatal unit- Short term outcomes and risk factors for mortality
title_sort abdominal surgery in very low birth weight neonates in a developing world neonatal unit short term outcomes and risk factors for mortality
topic Paediatric Medicine
url http://hdl.handle.net/11427/33439
work_keys_str_mv AT allienazneen abdominalsurgeryinverylowbirthweightneonatesinadevelopingworldneonatalunitshorttermoutcomesandriskfactorsformortality