Pattern and Outcome of Pediatric Surgical Admissions to a Nigerian Tertiary Hospital

Abstract

Background/Purpose: The patterns and the factors influencing outcome of paediatric surgical admissions may be crucial to policy formulation. This study reports the pattern and the outcome of paediatric surgical admissions in a developing country. Materials & Methods: The pattern and the outcome of paediatric surgical admissions at the University of Benin Teaching Hospital between January and December 2009 were audited in a retrospective study. Results: In total, 871 children aged between one day and 16 years who accounted for 43% of paediatric surgical workload were admitted, 322 (37%) on emergency basis. Of these, only 530 (60.8%) were admitted to a paediatric surgical ward while the rest were admitted in different wards, including nonsurgical wards, due to shortage of manpower and lack of paediatric surgical facilities. Three consultant paediatric surgeons and 17 nurses (only one paediatric nurse) managed an average of 46 new admissions per month with doctor to patient and nurse to patient ratio of 1: 15 and 1:33 respectively. Shortage of bed spaces also resulted in the admission of many clean surgical cases in the same ward with septic medical cases. This increased postoperative infective complications, duration of hospitalization and mortality rate especially among 106 neonates admitted to Special Care Baby Unit compared to those in paediatric surgical ward (P<0.0001). Conclusion: The need for the provision of more paediatric surgical facilities and training of more paediatric surgical personnel to match the high paediatric surgical workload is emphasized by this audit.

Index Word: Pattern, Paediatric, Surgical, Admissions, Outcome.