Pediyatrik Cerrahi Tarafından Opere Edilen Hastaların Demografik Özellikleri, Geçirdikleri Ameliyat Tipleri, Postoperatif Yatış ve Mortalite Oranlarının Anestezi Yaklaşımı Açısından Retrospektif Olarak İncelenmesi

Abstract

Hisarkaya S., Retrospective Evaluation of Demographic Characteristics, Types of Surgery, Postoperative Hospitalization and Mortality Rates of Patients Operated by Pediatric Surgery in Terms of Anesthetic Approach. Hacettepe University, Thesis in Anesthesiology and Reanimation, Ankara, 2024. Anesthesia practices in the pediatric patient group differ from those in adults in many ways. It is accepted that the risk of anesthesia is higher in pediatric patients compared to adults and this risk increases inversely with age in pediatric patients. Our aim in this study was to determine the gender and age group distribution, the most common surgical procedures performed, and to define the postoperative length of stay and mortality rates in patients operated on by pediatric surgery. The data of patients who underwent pediatric surgery in the period from 01.01.2022 to 31.12.2022 were accessed through the information operating system "Nucleus" and the following parameters were entered into the data collection form: gender, age, date of operation, surgical procedure, number of surgeries, postoperative hospitalization, discharge date if hospitalized, and excitus within 30 days postoperatively. Data analysis was performed using IBM SPSS Statistics 25.0 (IBM Corporation, Armonk, NY, USA) package program. 1553 surgical procedure pertaining to 1274 patients younger than 18 years of age who underwent surgery under general anesthesia were included in the study. The proportions of male and female patients was 70.7% and 29.3%, respectively. The most common age group to undergo surgery was young children (4-12 years) (49.0%) and the least common age group was neonates (2.3%). The most common surgical procedures were abdominal surgeries (21.7%) and the least common surgical procedure was trauma-related surgery (0.1%). Of 1553 cases, 810 (52%) were hospitalized postoperatively. Toddler (57.2%) and children of walking age (53.4%) were most frequently admitted to day surgery, while patients in the neonatal group (8.6%) were the least frequently admitted to day surgery. Of the 35 neonates in the study, 32 (91.4%) received postoperative hospitalization and the mean duration of hospitalization was 11 days. The hospitalization rate was significantly higher in neonates compared to other age groups (p<0.001). The longest lenght of stay was found in neonates and adolescents (p<0.001). In our study, postoperative 30-day mortality was evaluated in in medium/high-risk surgeries in which body cavities such as the abdomen and/or thorax were opened, as well as, tumor surgeries and port-a-cath procedures. In this group, our postoperative 30-day mortality rate in all patients was 10/655 (152 per 10,000). In these groups, there was no significant correlation between mortality and gender and number of previous operations, respectively. Regardless of other factors, hospital mortality was significantly higher in neonatal surgeries (OR=10.221; 95% CI: 2.561-40.797, p<0.001). As the length of stay prolonged, the likelihood of hospital mortality continued to increase significantly (OR=1.015; 95% CI: 1.002-1.028, p=0.029).