Incidence and associated factors of perioperative serious adverse Events in pediatric patients undergoing surgery in jimma University specialized hospital

Abstract

Background: Serious adverse events are the leading causes of morbidity and mortality of pediatric patients undergoing procedures in perioperative period . Perioperative serious adverse events related to anesthesia involve multiple factors. Patient characteristics and comorbidities play a role in many of these events, highlighting the importance of preoperative screening. There is a limited resource on perioperative serious adverse events in pediatric patients undergoing surgery in Jimma University specialized hospital. Objective: To assess the incidence and associated factors of perioperative serious adverse events in pediatric patients undergoing surgery in Jimma University Specialized Hospital. Methods: Hospital-based cross-sectional study was done, data was collected from August to November 2021 by anesthesiology residents and anesthetists after taking orientation on the questionnaire by the principal investigator and they were supervised daily throughout data collection time. Data was edited, coded and entered, and cleaned by Epidata manager version 4.6.0.6. First descriptive analysis was made, and bivariate analysis and multivariate logistic regression model was used by SPSS (version 25) to identify risk factors associated with perioperative Serious adverse events. Variables with p-value<0.25; candidates for MLR and P-Value <0.05 was considered statistically significant. Result: A total of 135 study subjects were included. The overall incidence of perioperative serious adverse events was 3.7%. Pediatric patients who had emergency surgery (AOR:1.42,95% CI:1.33,4.61), ASA classification III (AOR: 3.14,95% CI:1.3,5.32) and IV (AOR:3.31,95% CI:1.3,6.71) and airway event (AOR: 1.52, 95% CI: 1.46, 12.57) were more likely to have perioperative serious adverse events than their counter parts. Conclusion: Perioperative serious adverse events were common under pediatrics age during anesthesia. Independently positively associated factors were having emergency surgery, higher ASA classification and air way event. Most of the cases were recognized and managed early. On the basis of the findings, it is advisable that preoperative screening should be done, patients undergoing emergency surgery should be stabilized before the surgery and close monitoring and follow-up should be given for patients with higher ASA classification and also, avoid repetitive air way manipulation