Determinants of Surgical Outcomes of Small Intestinal Atresia at Kenyatta National Hospital,kenya
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Date
2021Author
Munyalo, Francisca S
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Background: Small intestinal atresia is the third most common cause of intestinal obstruction in
neonates. Advancements in the perioperative management of these patients have led to better
survival rates and outcomes in developed countries, however, such outcomes in the developing
countries have not been recorded. Several factors such as age at surgery, associated anomalies,
type of atresia, availability of neonatal ICU and Total Parenteral Nutrition, time taken to reach
full feeds, have been found to have an influence on the outcome of these patients.
The study aimed to establish determinants of surgical outcome of small intestinal atresia at
Kenyatta National Hospital.
Study objective: To determine the factors that affect surgical outcomes of small intestinal atresia
at Kenyatta National Hospital.
Study design: A retrospective cross-sectional study
Methods: Records of neonates admitted to Kenyatta National Hospital with a diagnosis of small
intestinal atresia from January 2014 to October 2020 who fit the inclusion criteria were retrieved.
Data on demographics, clinical findings, perioperative findings and outcomes were extracted.
Data management and analysis: Data collected was entered into spreadsheets and analyzed
using SPSS version 24 software to determine any significant relationships. Data was then
summarized into frequencies and percentages for categorical data and mean with standard
deviation for continuous data. Factors influencing the surgical outcome were analyzed with
Pearson Chi square tests and those with significant associations were subjected to multivariate
analysis with use of logistic regression.
Results: 135 patient files were studied. Significant factors which influenced mortality were
presence of associated anomalies, type of atresia and use of TPN. The most common
complications encountered were anemia, jaundice and sepsis. Mortality was at recorded at
56.3%.
Conclusion: The mortality rate seen at KNH is high. Though the factors which have been found to
increase the survival rate of SIA in developed countries are available at KNH, they are few and
strained to cater for all neonates at KNH. It is recommended to increase the capacity of NICU at
KNH and to have CVC inserted so as to facilitate TPN administration.
Study utility: The study will pave way for the development of new management protocols that
can be practiced at KNH which will lead to improved short and long term outcomes. Information
gained from this study will aid in updating healthcare workers at peripheral facilities on pretransfer
stabilization and optimization of these neonates.
Publisher
UON
Subject
intestinal, atresia, outcomesRights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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