Key result
Upper respiratory tract infections significantly increased the risk of perioperative respiratory adverse events in pediatric surgical patients (AOR 7.6).
Cross-Sectional (n=210)
Yes
Odds Ratio: 7.6 (95% CI 1.9–30.2)
Absolute Event Rate: 73.9% vs 20.3%
p-value: p=0.004
Perioperative respiratory adverse events are common in pediatric surgical patients, particularly in those under 1 year of age, with ASA ≥ 3, or with upper respiratory tract infections.
26% PRAE incidence signals need for preoperative risk stratification in resource-limited settings; leaves open whether targeted interventions reduce events in prospective trials.
Introduction: Perioperative respiratory adverse events (PRAEs) are the most frequent complications in pediatrics which frequently result in morbidity and mortality. They are accountable for 75% of perioperative critical incidents and 33% of cardiac arrests. The occurrence and severity of PRAEs depends on the natures of surgery, anesthesia & patient’s status.Objective: To assess the incidence and factors associated with PRAEs in general anesthesia among pediatric surgical patients at the University of Gondar and Tibebe-Ghion Comprehensive Hospital and Specialized Hospitals, Northwest Ethiopia, 2020.Methods: After obtaining the ethical approval, a hospital-based prospective cross-sectional follow-up study was conducted among pediatric surgical patients who underwent variety of surgical operations. A total of 225 patients were included. The associations between independent variables and the outcome variables were determined at 95% CI with the Chi-squared test, Fisher–exact test, bivariate, and multivariate logistic regression. Hosmer-Lemeshow test was used to assess the goodness of fit. Variables with a p-value < 0.05 were considered significant.Results: The incidence of PRAEs among 210 (93.3% response rate) pediatrics surgical patients was 26.2% (95% CI: 20.5, 30.9). A total of 129 episodes of PRAEs were observed. Most of the adverse events (89 (69.0%)) were occurred postoperatively. Desaturation was found to be the predominant adverse event which was occurred 61 (47.3%) times. Age < 1 year (AOR: 3.6, 95% CI: 1.3, 10.0), ASA ≥ 3 (AOR: 5.2, 95% CI: 1.9, 22.9), upper respiratory tract infections (AOR: 7.6, 95% CI: 1.9, 30.2), presence of secretions in the upper airway (AOR: 4.8, 95% CI: 1.4, 15.9) and airway related procedures (AOR: 6.0, 95% CI: 1.5, 24.1) were significantly associated PRAEs.Conclusions: The incidence of PRAEs among pediatric surgical patients was relatively high (26.2%). Especially, the postoperative phase is the most critical time for the occurrence of PRAEs and desaturation was the predominant adverse event. Age less than a year, presence of upper respiratory tract infections, presence of secretions in the upper airways, ASA ≥ 3 and airway related procedures were associated with PRAEs. Clinicians should carry out effective risk assessment, optimization and adequate preparation for the management of perioperative respiratory adverse events.
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Berhe et al. (2021) conducted a cross-sectional in Pediatric surgical patients undergoing general anesthesia (n=210). Upper respiratory tract infections (URTIs) vs. No upper respiratory tract infections was evaluated on Perioperative respiratory adverse events (PRAEs) (AOR 7.6, 95% CI 1.9-30.2, p=0.004). Upper respiratory tract infections significantly increased the risk of perioperative respiratory adverse events in pediatric surgical patients (AOR 7.6).
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