Outcomes following the establishment of Qatar’s quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development

Authors

  • Basem A Khalil Alder Hey Children's Hospital
  • Abdalla E Zarroug
  • Abubakr Elawad
  • Saad Moussa
  • Collette Donnelly
  • Saleem Mammoo
  • Guy Brisseau
  • Alison Bedford Russell
  • Helmut Hummler

DOI:

https://doi.org/10.47338/jns.v10.975

Keywords:

Neonatal surgery, Mortality, Gulf region

Abstract

Background: Sidra Medicine is the first dedicated Children and Maternity hospital in the State of Qatar. This paper describes the preparations for and results of activating quaternary neonatal surgical services in a brand new, "greenfield" hospital. We believe that these are the first published national results of neonatal general surgical services from the Gulf region.

Methods: A review of surgical babies below four weeks corrected age from 1st of April 2018 – 31st of March 2020 was undertaken. Patient demographics, primary diagnosis, surgical procedures, 30-day postoperative mortality, overall mortality, and cause of death were recorded.

Results: One hundred and sixty-nine babies (169) were identified (44.4% term and 55.6% preterm). Major surgery included laparotomy (76), congenital diaphragmatic hernia repair (20), surgery for anorectal malformations (25), and esophageal atresia (13). One set of conjoined twins were also separated successfully.  Fourteen babies died, resulting in overall mortality of 8.3 %. Excluding babies who died of life-limiting conditions, two babies died within 30 days of surgery, resulting in 30 days postoperative mortality rate of 1.2 %.

Conclusions: The neonatal surgical mortality rate is comparable with those from top international centers. This low rate could be attributed to the high level of expertise preceded by months of preparations.

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Author Biographies

Basem A Khalil, Alder Hey Children's Hospital

Consultant Paediatric Surgeon, Alder Hey Children’s Hospital, Liverpool, UK

Former Director of Neonatal Surgery, Sidra Medicine, Doha, Qatar

Abdalla E Zarroug

Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar

Abubakr Elawad

Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar

Saad Moussa

Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar

Collette Donnelly

Advanced Paediatric Nurse Practitioner (General Surgery) Royal Belfast Hospital for Sick Children

Former Advanced Nurse Practitioner, Division of Paediatric Surgery, Sidra Medicine, Qatar

Saleem Mammoo

Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar

Guy Brisseau

Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar

Alison Bedford Russell

Senior Attending Neonatologist and Former Deputy Chief, Division of Neonatology and Neonatal Intensive Care, Sidra Medicine, Doha, Qatar

Helmut Hummler

Former Chief, Division of Neonatology and Neonatal Intensive Care, Sidra Medicine, Doha, Qatar

References

Yagi M, Kohno M, Asagiri K, Ikeda T, Okada T, Kanada S, et al. Twenty-year trends in neonatal surgery based on a nationwide Japanese surveillance program. Pediatr Surg Int. 2015; 31:955-62. Available from: https://doi.org/10.1007/s00383-015-3775-z.

Taguchi T. Current progress in neonatal surgery. Surg Today. 2008; 38: 379–89. Available from: https://doi.org/10.1007/s00595-007-3657-7.

Tauro JK, Walker K, Halliday R, Jatana V, Trivedi A. Trends in mortality in an Australian tertiary surgical neonatal intensive care unit. J Neonatal Surg. 2018; 7. Available from: https://doi.org/10.21699/jns.v7i1.677.

Saggers RT, Ballot DE, Grieve A. An analysis of neonates with surgical diagnoses admitted to the neonatal intensive care unit at Charlotte Maxeke Johannesburg Academic Hospital, South Africa. S Afr Med J. 2020; 110:497–501.

Flynn-O'Brien KT, Richards MK, Wright DR, Rivara FP, Haaland W, Thompson L, et al. Health outcomes and the health care and societal cost of optimizing pediatric surgical care in the United States. J Pediatr Surg. 2019; 54: 621–7. Available from: https://doi.org/10.1016/j.jpedsurg.2018.10.102.

Stone ML, LaPar DJ, Mulloy DP, Rasmussen SK, Kane BJ, McGahren ED, et al. Primary payer status is significantly associated with postoperative mortality, morbidity and Hospital Resource Utilization in Pediatric surgical patients within the United States. J Pediatr Surg, 2013; 48:81–7. Available from: https://doi.org/10.1016/j.jpedsurg.2012.10.021.

France DJ, Slagle J, Schremp E, Moroz S, Hatch LD, Grubb P, et al. Impact of patient handover structure on neonatal perioperative safety. J Perinatol. 2019; 39:453–7. Available from: https://doi.org/10.1038/s41372-018-0305-6.

Bhatt D, Travers C, Patel RM, Shinnick J, Arps K, Keene S, et al. Predicting mortality or intestinal failure in infants with surgical necrotizing enterocolitis. J Pediatr. 2017; 191:22–7. Available from: https://doi.org/10.1016/j.jpeds.2017.08.046.

Rogowski JA, Staiger DO, Patrick TE, Horbar JD, Kenny MJ, Lake ET. Nurse staffing in neonatal intensive care units in the United States. Res Nurs Health. 2015; 38:333–41. Available from: https://doi.org/10.1002/nur.21674.

Glass HC, Costarino AT, Stayer SA, Brett C, Cladis F, Davis PJ. Outcomes for extremely premature infants. Anesth Analg. 2015; 120:1337–51. Available from: https://doi.org/10.1213/ANE.0000000000000705.

Skertich NJ, Ingram ME, Ritz E, Shah AN, Raval MV. The influence of prematurity on neonatal surgical morbidity and mortality. J Pediatr Surg. 2020; 55:2608-13. Available from: https://doi.org/10.1016/j.jpedsurg.2020.03.024.

Published

2021-08-09

How to Cite

1.
Khalil BA, Zarroug AE, Elawad A, Moussa S, Donnelly C, Mammoo S, Brisseau G, Bedford Russell A, Hummler H. Outcomes following the establishment of Qatar’s quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development. J Neonatal Surg [Internet]. 2021Aug.9 [cited 2021Sep.21];10:32. Available from: https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/975

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Section

Original Article