Paediatric anaesthesia & critical care
Outcomes after surgery for children in Africa (ASOS-Paeds): a 14-day prospective observational cohort study
Authors' conclusion
Outcomes following anaesthesia and surgery for children in Africa are poor, with complication rates up to four-fold higher (18% vs 4.4-14%) and mortality rates 11-fold higher than high-income countries in a crude, unadjusted comparison (23.15 deaths vs 2.18 deaths per 1000 children).
Study context
- Population
- Children (aged <18 years) undergoing surgery in hospitals in Africa, all levels of care
- Participants
- 8,625 children · 249 hospitals · 31 countries
- Outcome
- In-hospital postoperative complications
- Follow-up
- Within 30 days of surgery
Methodological detailsinternational, multicentre, 14-day, consecutive patients, Mean age 6.1 (SD 4.9) years; 5675 (66.0%) of 8600 male, ASA 1: 6110 [71.2%] of 8579; elective surgery: 5325 [61.9%] of 8604
- International
- Multicentre
- 14-day
- Consecutive patients
- Mean age 6.1 (SD 4.9) years; 5675 (66.0%) of 8600 male
- ASA 1: 6110 [71.2%] of 8579; elective surgery: 5325 [61.9%] of 8604
Main finding
As reported in the abstract
Postoperative complications
1532 (18.0%) of 8515 children
Infections
971 [11.4%] of 8538 children
Observational data: associations, not effects.
Secondary outcomes
In-hospital mortality within 30 days
- Deaths
- 199 (2.3%) of 8596 patients
- Deaths following emergency surgeries
- 169 (84.9%) of 199 patients
- Deaths following postoperative complications
- 166 (10.8%) of 1530 complications
Operating rooms reported safe for anaesthesia and surgery (hospital level)
- Neonates
- 121 [54.3%] of 223 hospitals
- Infants
- 147 [65.9%] of 223 hospitals
- Children younger than 6 years
- 188 [84.3%] of 223 hospitals
Original publication
Outcomes after surgery for children in Africa (ASOS-Paeds): a 14-day prospective observational cohort study. Lancet. Published 22 March 2024. doi:10.
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