INCIDENCE OF POSTOPERATIVE RESPIRATORY ADVERSE EVENTS AND PREDICTING FACTORS AMONG PEDIATRIC PATIENTS OPERATED AT HAWASSA UNIVERSITY COMPREHENSIVE SPECILIZED HOSPITAL:SINGLE ARM PROSPECTIVE COHORT STUDY

Abstract

Background: Postoperative Respiratory Adverse Events (PREAs) is the impairment of the respiratory system that occurs with the combination of patient condition, anesthetics, and surgical factors. This may result in an extended hospital stay, financial strain on the family, and may increase morbidity and mortality. The objective of this study is to assess the incidence of postoperative respiratory adverse events and predicting factors among pediatric patients operated at Hawassa University Comprehensive Specialized Hospital from January 10-March 30, 2024. Methods: A prospective cohort study was done with a total of 205 pediatric patients aged 0-15 years were included by using systematic random sampling. Data were collected by using structured questionnaire, entered into Epi-Data, and exported to SPSS version 26 for performing data analysis. Categorical data was analysed by using the chi-squared test, and normally distributed continuous data were analysed by using student t-test. Binary logistic regression was done to identify predicting factors of postoperative respiratory adverse events. Multivariable logistic regression was done in order to identify independent predicting factors of the postoperative respiratory adverse events. In the final model AOR and 95% CI were used to measure of the strength of association and statistical significance respectively, at p-value <0.05. Results: Among a total of 205 patients operated on at Hawassa University Comprehensive Specialized Hospital, the incidence of postoperative respiratory adverse events was 35.6 % with the 95%CI (28.8 – 42.9). Intraoperative use of opioids (AOR: 2.9, 95% CI:1.24-6.8), spontaneous ventilation (AOR: 4.68, 95% CI: 1.94-11.28), upper respiratory tract infection (AOR: 5.03, 95% CI: 1.84-13. 78), general anaesthesia with a cuffed endotracheal tube (AOR: 3.31, 95% CI: 1.23-8.91), age less than 1 month (AOR: 9.2, 95% CI: 1.1-77.2) and age less than 2 years (AOR:4.7,95% CI: 1.06-20.8) were independent predicting factors of postoperative respiratory adverse events. Conclusion: The postoperative respiratory adverse event among pediatric patients operated at Hawassa University Comprehensive Specialized Hospital was high. Intraoperative use of opioids, spontaneous ventilation technique, patients that have an upper respiratory tract infection, general anesthesia with a cuffed endotracheal tube, and age less than two years were independent predicting factors postoperative respiratory adverse events..