Risk factors analysis of postoperative adverse events in newborns under the integrated management of internal and external departments in the ward / 局解手术学杂志

ABSTRACT

Objective To summarize the occurrence of postoperative adverse events in neonatal surgery under the integrated manage-ment of internal and external departments in the ward of West China Second University Hospital,Sichuan University,and analyze the risk factors affecting postoperative adverse events.Methods A total of 272 newborns who underwent surgical procedures in West China Second University Hospital,Sichuan University from January 2019 to December 2021 were included.The occurrence of postoperative comprehen-sive adverse events was recorded,and the newborns were divided into the symptomatic group and the asymptomatic group according to the occurrence of complications.The high-risk factors that affecting postoperative adverse events in neonatally surgical procedures were analyzed by univariate analysis and multivariate analysis.Results There were 108 newborns experienced comprehensive adverse events after surgery.The results of univariate analysis showed that there were statistically significant differences in the proportion of male newborns,gestational age,birth weight,Apgar score 1 minute postpartum,the proportion of newborns with preoperative diagnosis of necrotizing small enteritis or/and gastrointestinal perforation,premature infants and low birth weight infants,the proportion of newborns with respiratory control when admitted to the operating room and mean arterial pressure(MAP),the proportion of newborns underdoing emergency surgery,and intraoperative infusion of red blood cell suspension between the two groups(P<0.05).The results of multivariate Logistic regression analysis showed that the small gestational age(OR=0.972,95%CI=0.950～0.994,P=0.014)and low MAP when admitted to the operating room(OR=0.955,95%CI:0.919～0.993,P=0.019)were the independent risk factors affecting the occurrence of postoperative adverse events in newborns.Conclusion Under the integrated management of internal and external departments in the ward,the small gestational age and low MAP when admitted to the operating room are the independent risk factors for the occurrence of postoperative adverse events in newborns.Improving the prenatal diagnostic measures and optimizing the time of fetal growth in and out of utero to reduce the associated effects of gestational age,and increasing the neonatal blood pressure when admitted to the operating room may reduce the incidence of postoperative adverse events in newborns and improve long-term prognosis.