Mortality, morbidity, and associated complications in paediatric anaesthesia in Mongolia

Abstract

Paediatric procedures requiring anaesthesia have been increased in varied locations, from tertiary children’s hospitals to remote provincial hospitals due to population growth and socio-economic advancements in Mongolia.

The objective of this study is to assess the incidence of paediatric anaesthesia related mortality and morbidity with the aim of enhancing preventive measures against these complications in paediatric anaesthesia in Mongolia. We conducted a retrospective cross-sectional study across multiple centres, analysing data on anaesthesia related complications.

Following approval from the Research Ethics Committee of the Maternal Child Health of Mongolia and the ethics committees of the provincial hospitals, a total of 60546 anaesthesia related records were reviewed and analysed.In total, 1160 anaesthesia related events, including 11 serious complications were reported from 637 patients’ records.

During the study period, serious complications including cardiac arrest n=10 (1:1000), and severe neurological damage n=1 (0.1:1000) occurred. The most common intraoperative complications were cardiovascular n=479 (79:1000 cases), including tachycardia n=169 cases of tachycardia, and 108 cases of hypotension. 283 (44:1000 cases) respiratory complications were noted the during anaesthesia period with laryngospasm being the most common (n=172 (13.9%)).Cardiovascular and respiratory events were most common in the post anaesthesia period. Moreover, fever n=132 and vomiting n=37, as well as shivering n=50 complications occurred in peri and post anaesthesia period during study period.

There is a significant need not only to advance anaesthesia techniques but also to develop strategies, including safety improvement management, hospital and operating theatre management and advanced training. Therefore, a prospective cohort study will be necessary in the upcoming years.