Abstract
Aim: The aim of the study was to estimate mortality rate and trend in the neonate admitted to a surgical neonatal intensive care unit.Methods: This study was a retrospective cohort analysis of all neonatal (from birth toResults: There were a total of 8994 admissions with 425 deaths during the study period, of whom 328 infants met inclusion criteria. In this group 18.9% (n=62) were admitted for a surgical condition, 35.4% (n=116) for cardiac disease and 45.7% (n=150) for other reasons. The median birth weight was 2715g (IQR 1890g-3220g) and the median gestational age was 37 weeks (IQR 33-39 weeks). The inter-quartile range for length of stay was between 2 to 20 days. The overall mortality rate was 3.6% over 16 years. There was a decline in mortality rate from 5.9% in 2000 to 3.5% in 2015 (p=0.06). Female infants accounted for 41% of the deaths. On multivariate analysis only very low birth weight was an independent predictor of mortality for surgical and cardiac deaths compared to deaths by other cause.Conclusions: There has been an overall decline in mortality in the surgical neonatal population from 2000 to 2015.
Highlights
Changes in neonatal care and obstetric care including antenatal corticosteroids for women at risk of preterm delivery, surfactant for respiratory distress syndrome and postnatal steroids for chronic lung disease have been associated with decrease in neonatal mortality especially among very low birth weight infants in the 1990s [1]
There were a total of 8994 admissions and 425 deaths between 2000 and 2015. 328 deaths fitted the inclusion criteria with an overall mortality rate of 3.6% over the study period (Figure 1)
Mortality: There was an overall decline in mortality rate from 5.9% in 2000 to 3.5% in 2015 (Figure 2)
Summary
Changes in neonatal care and obstetric care including antenatal corticosteroids for women at risk of preterm delivery, surfactant for respiratory distress syndrome and postnatal steroids for chronic lung disease have been associated with decrease in neonatal mortality especially among very low birth weight infants in the 1990s [1]. The steady decline in neonatal mortality has continued in the last decade across neonatal cohorts from United States and Europe [2,3,4,5,6]. With advances in neonatal practice, surgical techniques and anaesthesia, there appears to be a general declining trend in mortality associated with neonatal surgery [7]. The improved survival over the years seems to be related to combination of different factors which include advances in paediatric surgery and paediatric anaesthesia; advances in neonatal intensive care including mechanical ventilation, parenteral nutrition, antibiotics, better understanding of neonatal physiology and technological advances [7]. A literature search for mortality in neonatal surgical units identified one study which examined inhospital mortality for non-cardiac surgery in 2000.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
