Predictors of Survival: A Retrospective Review of Gastroschisis and Intestinal Atresia in Rwanda

Neonatal surgical diseases are prime examples of the global disparity in surgical access and outcomes, with survival for conditions like gastroschisis reaching above 95% in high-income settings but usually fatal in low-income settings. This study aims to examine outcomes and predictors of mortality...

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Bibliographic Details
Published in:The Journal of surgical research 2022-05, Vol.273, p.138-146
Main Authors: Davis, James R., Nsengiyumva, Alice, Igiraneza, Deborah, Hong, Philip, Umutoni, Rosine, Neal, Dan, Petroze, Robin T., Ntaganda, Edmond
Format: Article
Language:English
Subjects:
Child
Gastroschisis
Gastroschisis - complications
Gastroschisis - surgery
Global surgery
Hospitalization
Humans
Infant, Newborn
Intestinal atresia
Intestinal Atresia - complications
Intestinal Atresia - epidemiology
Intestinal Atresia - surgery
Outcomes
Retrospective Studies
Rwanda
Rwanda - epidemiology
Treatment Outcome
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Summary:Neonatal surgical diseases are prime examples of the global disparity in surgical access and outcomes, with survival for conditions like gastroschisis reaching above 95% in high-income settings but usually fatal in low-income settings. This study aims to examine outcomes and predictors of mortality in patients with two specific neonatal surgical conditions that often require early transfer and prolonged inpatient care (gastroschisis and intestinal atresia) at Rwanda’s main pediatric referral hospital. A single-institution retrospective chart review of neonates with gastroschisis and intestinal atresia was conducted between January 2016 and June 2019. Abstracted data included demographics, referral history, admission interventions, operative details, in-hospital complications, nutrition patterns, length of stay, and mortality. Daily logs were created to evaluate feeding status, infection status, and antibiotic usage. Descriptive and univariate analysis was conducted, with the primary outcome being survival to hospital discharge. A total of 112 patients met inclusion criteria (82% gastroschisis [n = 92] and 18% intestinal atresia [n = 20]). Median age at arrival was 0 d (GS) [IQR 0-1 d] and 8.5 d (IA) [IQR 4-10 d] (P 
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2021.12.035