Postoperative Outcome in Children Aged between 6 and 10 Years in Major Abdominal Surgery, Neurosurgery and Orthopedic Surgery ()
ABSTRACT
Background: Anticipating
postoperative evolution in surgical patients is an important issue in our daily
practice. We demonstrated in a previous study that
there were multiple predictors of postoperative outcome, including American Society of Anesthesiologists status (ASA), transfusion, emergency,
surgery and age. A secondary analysis describing intraoperative and
postoperative outcomes was undertaken in children aged between 6 and 10 years
old included in the initial study. Objective: To describe intraoperative
and postoperative outcomes in children aged between 6 and 10 years old included
in the initial cohort in abdominal surgery, neurosurgery and orthopedics. Methods: The secondary analysis of postoperative outcomes in children aged between 6
and 10 years old was retrospectively included in
the initial study of 594 patients. The study was approved by the Ethics
Committee. Results: There were 88 patients with a mean age of 98.7 ± 13.8 months. The most common surgical interventions were scoliosis in 23
patients (26.1%), limb tumor resection in 8 patients (9.1%), femoral osteotomy
in 6 patients (6.8%), intracerebral tumor resection in 6 patients (6.8%), intestinal
resection in 5 patients (5.6%), Chiari’s malformation in 4 patients (4.5%),
pelvic osteotomy in 4 patients (4.5%) and renal transplantation in 4 patients
(4.5%). Most patients (45%) were American Society of Anesthesiologists grade 3
(ASA 3), and 13 (14.8%) were ASA grade 4. Twenty-two (25%) patients had
intraoperative and/or postoperative complications (organ dysfunction or
sepsis). Two patients (2.3%) had intraoperative hemorrhage, 1 patient (1.1%)
had intraoperative difficult intubation, and 1 patient experienced
intraoperative anaphylaxis. Nine patients
(10.2%) had postoperative neurologic failure, and 2 (2.3%) had
postoperative cardio-circulatory failure. Three patients (3.4%) had
postoperative septicemia, 2 patients (2.3%) had postoperative pulmonary and
urinary sepsis, and 1 patient (1.1%) had postoperative abdominal sepsis. 3
patients (3.4%) had re-operations. 42 (47.7%) patients had intra-operative transfusion. There was 1 in-hospital
death (1.1%). The median total length of hospital stay was 9 days [5 - 16]. Conclusion: Twenty-five percent of the patients had
intraoperative and/or postoperative complications, and most of them were ASA
grade 3 3. Integrating goal-directed therapies to optimize intraoperative
management in these patients could be necessary to improve postoperative
outcomes in surgical pediatric patients.
Share and Cite:
Kumba, C. (2021) Postoperative Outcome in Children Aged between 6 and 10 Years in Major Abdominal Surgery, Neurosurgery and Orthopedic Surgery.
Open Journal of Pediatrics,
11, 636-645. doi:
10.4236/ojped.2021.114059.