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Category: Volume 07 Issue 07 July 2019
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Title: Audit of Paediatric Surgical Services in a Tertiary Care Hospital in Maharashtra, India

Authors: Minakshi Bhosale, Varsha Soni

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.78

Abstract

Objective: Aim of this study is to assess the paediatric surgical caseload, spectrum of paediatric surgical conditions managed, various paediatric surgical operative procedures performed and outcome of the same in existing set-up.

Methods: It is retrospective analysis of the paediatric surgical services provided by a single unit in a tertiary care hospital affiliated to State Government run Medical College in Maharashtra, India. The study period extends from January 2016 to December 2018. Data acquisition was done by compiling and cross -checking the computerized and non-computerized hospital records. Total 2577 children from day one old neonate up to 15 years of age with surgical disorders were included in this study. There were 1518 male children and 1059 female children. Among these, 986 were neonates.

Results: Percentage bed occupancy averaged 90%. The most common diagnoses on admission were congenital anomalies (90.25%), surgical infections (6.2%) followed by trauma (3.4%). Forty-six different operative procedures were performed. Paediatric surgical procedures accounted for 2.5% of all operations carried out in the hospital during the study period. Overall mortality was 9.1%. Peri-operative mortality was 2.9%.

Conclusions: This study aims to emphasize the spectrum of work done by paediatric surgery unit in the set up of tertiary care hospital affiliated to State Government run Medical College. It also highlights the need of strengthening the paediatric surgical services by establishing full-fledged paediatric surgery department with separate surgical ward and well-equipped surgical intensive care unit. This will ensure prompt and improved patient care and help bring down morbidity and mortality of children requiring surgical intervention.

Keywords: Audit, Paediatric Surgical Services, Congenital Anomalies, Neonatal Surgery, Tertiary Care Hospital, Childhood Injuries.

References

  1. Frostick SP, Radford PJ, Wallace WA. Medical audit: Rationale and Practicalities. Cambridge: Cambridge University Press; 1993. 
  2. Clinical audit, From Wikipedia, the free encyclopedia. Available from: http://www.en.wikipedia.org/wiki/Clinical_audit.
  3. David C. Dunn. Surgical Audit. Editorial 2. The National Medical Journal Of India Vol. 5, No.2 ;50-51
  4. World Health Organization. Global initiative for emergency and essential surgical care [Internet site]. Geneva: WHO. Available from:  http://www.who.int/surgery/globalinitiative/en/.
  5. World Health Organization. Integrated management for emergency and essential surgical care (IMEESC) toolkit Geneva: WHO. Available from: http://www.who.int/surgery/publications/imeesc/en/index.html.
  6. World Health Organization. WHO guidelines for safe surgery: 2009: Safe surgery saves livesGeneva: WHO; 2009.
  7. Osifo OD, Aduwa IP. Pattern and Outcome of Pediatric Surgical Admissions to a Nigerian Tertiary Hospital. Annuals of Pediatric surgery 2010; Vol 6, No 3-4:161-6
  1. Nwomeh BC, Mshelbwala PM. Pediatric surgical specialty: How relevant to Africa? Afr J Paediatr Surg 2004;1:36-42 
  2. Walker IA ,  Obua AD,  Mouton F, Ttendo S,   Wilson Bull World Health Organ 2010; 88(12): 897-906
  3. Bickler SW, Sanno-Duand B. Epidemiology of pediatric surgical admission to a government referral hospital in the Gambia. Bulletin of the World Health Organ 2000;78(11):1330-6
  4. Division of Pediatric Surgery, Center for Pediatric Surgical Clinical Trials and Outcomes Research. Johns Hopkins University School of Medicine;2004.125-130
  5. Saunik S, Jaiswal C, Nair R, Radkar A, Patil A, Irani S, et al. Analysis of neonatal deaths in Maharashtra: policy implications. Int J Community Med Public Health 2017;4:4513-9
  6. Bickler SW, Rode H. Surgical services for children in developing countries. Bull World Health Organ 2002;80(10): 829-35
  7. Thanni LO, Shonubi AM, Akiode O. A retrospective audit of paediatric surgical admission in a sub-urban tertiary hospital. West Afr J Med 2005;24(1):10-2
  8. Tsegaye Ketema, Sileshi Garoma Abeya, Kalide Abdela, Tolossa Eticha Chak Pediatric Surgical Admissions and Their Outcomes at Adama Hospital Medical College: A Facility Based Cross Sectional Study. American Journal of Pediatrics 
    2017;Volume 3, Issue 4: 23-27 
  9. Copeland GP, Jones D, Walters  M . POSSUM: a scoring system for surgical audit. Br J Surg 1991;78:355-60
  10. Graham Paul Copeland. The POSSUM System of Surgical Audit. Arch Surg2002;137(1):15-19. doi:10.1001/archsurg.137.1.15
  11. Ameh EA, Chirdan LB. Paediatric surgical in the rural setting: prospect and feasibility. West Africa journal of Medicine 2001;201: 52-5

Corresponding Author

Dr Minakshi Sham Bhosale

G / 101, Sudarshan Apartments, Behind Spencer’s Daily, Karvenagar, Pune - 411 052 Maharashtra, India