LETTERS TO THE EDITOR
|Year : 2022 | Volume
| Issue : 4 | Page : 512
Critical appraisal of the article entitled “Evaluation of risk factors affecting the outcomes of outborn surgical neonates”
Department of Paediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
|Date of Submission||30-Nov-2021|
|Date of Acceptance||26-Dec-2021|
|Date of Web Publication||26-Jul-2022|
Tower 3, Flat 303, Common Wealth Games Village, Delhi 110 092
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Puri A. Critical appraisal of the article entitled “Evaluation of risk factors affecting the outcomes of outborn surgical neonates”. J Indian Assoc Pediatr Surg 2022;27:512
|How to cite this URL:|
Puri A. Critical appraisal of the article entitled “Evaluation of risk factors affecting the outcomes of outborn surgical neonates”. J Indian Assoc Pediatr Surg [serial online] 2022 [cited 2022 Aug 9];27:512. Available from: https://www.jiaps.com/text.asp?2022/27/4/510/352288
We read with interest the article titled “Evaluation of risk factors affecting outcome in outborn surgical neonates” published in September issue of this journal. Neonatal surgical mortality (NSM) contributes significantly to neonatal mortality and its audit and documentation as done in this paper are absolutely imperative. The authors reported their experience on 120 surgical neonates over a period of 18 months. The paper, however, failed to provide important scientific details such as the overall survival rate, crucial clinical details on use of inotropes (like the dosage, duration, and names of inotropes), type and duration of respiratory support that was associated with adverse outcome. In the absence of these details, the readers fail to understand the clinical implications of their reported findings. Furthermore, the duration of surgery was intended to be studied in methodology but was not reported in results. Missing data were spotted in reviewing the values of serum calcium and potassium among survivors in Table 3.
A recently published study in earlier issues of this journal from our center alluded on preoperative, intraoperative, and postoperative variables and studied their impact on NSM by multivariate logistic regression analysis. Factors identified as predictors of NSM were duration of surgery >120 min, especially in low birth weight, preterm babies with higher illness severity score (odd's ratio: 9.76), need for prolonged mechanical ventilation (odd's ratio: 5.77), major complication requiring reoperations (odd's ratio: 7.16), and requirement of high dose of vasopressors (Dopamine and dobutamine (>10 μg/kg/min) and adrenaline (0.05–0.3 μg/kg/min) increased the odds of mortality by 25.65 times. In this study, numerical graded scores were assigned to preoperative (0–12), intraoperative (0–12), and postoperative variables (0–10). The area under the receiver operator characteristic analysis for preoperative, intraoperative, postoperative scores was 0.694, 0.816, and 0.912, respectively, suggesting a significant strong positive correlation of intraoperative and postoperative scores with NSM. It was surprising that the findings of this study were not discussed in this paper.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Mohta A, Mishra A, Khan NA, Jajoo M, Neogi S, Sengar M, et al.
Evaluation of risk factors affecting outcome in outborn surgical neonates. J Indian Assoc Pediatr Surg 2021;26:307-10. [Full text]
Puri A, Lal B, Nangia S. A pilot study on neonatal surgical mortality: A multivariable analysis of predictors of mortality in a resource-limited setting. J Indian Assoc Pediatr Surg 2019;24:36-44.
] [Full text]