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Outcome of declined neonatal surgical referrals at Cairo University Specialized Pediatric Hospital.

Abstract：

BACKGROUND:The combination of a high birth rate and limited resources leads to a strain on health services with dire consequences to the patient. This study aimed to track the outcome of declined referrals at the tertiary center in the Cairo University Specialized Pediatric hospital. METHODS:Data were collected prospectively on all declined surgical neonates at the tertiary center. The families were later contacted to document outcomes. Verbal consent was taken. FINDINGS:Over a 12 month period from January 2017 to December 2017, 668 neonatal surgical referrals were received. Of these 278, (41·6%) were declined for lack of available places. The majority were cases of esophageal atresia with tracheoesophageal fistula (35%), followed by bowel obstruction (21%). Thirty-six cases were lost to follow up. Of the remaining 242 cases, 103 (42·5%) died, 63 (26%) were referred to public hospitals, 69 (28·5%) to private hospitals and seven (2·8%) were managed conservatively. CONCLUSIONS:Nearly half of neonatal surgical cases die while waiting for surgical intervention. Cases were shared equally between the public and private sector. The collected data are crucial in planning service provision for neonates requiring surgical treatment. To the best of our knowledge, this is the first study from Egypt and the region to report the number and outcome of surgical neonates who do not get access to expert surgical services. The study outlines the burden of disease faced by a single pediatric surgery unit and documents the various congenital anomalies encountered as well as their outcome when treated elsewhere. STUDY TYPE:Prognosis study. LEVEL OF EVIDENCE:IV.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Shalaby A,Ragab M,Bahaaeldin K

doi

10.1016/j.jpedsurg.2019.09.002

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

518-522

issue

3

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(19)30648-7

journal_volume

55

pub_type

杂志文章

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