Authors: Daddy H, Chaïbou MS, Gagara M, Nainou Guero A, Younsa H, Kadi I, Sani R.
Objective: The aim of this study is to audit the perioperative deaths of patients operated on at Niamey National Hospital (HNN).
Patients and Methods: This is a cross-sectional prospective study from January to December, 2018; one (1) year. Have been included all patients who died in operating room or within 24 hours of surgery. Audit team is composed of a senior surgeon and two anesthetists. The following variables were studied: age, sex, patient history, American Society of Anesthesiologists (ASA) classification, Mallampati score, surgical indication, type of anesthesia, induction and maintenance drugs, perioperative incidents and accidents, imputation and cause of death. Data were analyzed with Word 2007 and Epi Info 6TM (Centers for Disease Control and Prevention Atlanta, GA).
Results: During the period of our study, 5411 patients had been operated. There were 37 perioperative deaths, a frequency of 0.68%. The average age of death patients was 27.52 years, with a sex ratio of 2.7. Digestive surgery was the most concerned followed by neurosurgery with 67.57% and 13.51% respectively. Surgery was performed in emergency in 89.19% and elective in 10.81% of cases. Patients were classified ASA1 in 8.11%; ASA2 in 40.54% and ASA3 in 27.03%. All of death patients were operated on under general anesthesia. Hypotension was the most common incident in the intraoperative and postoperative periods, with 51.35% and 18.92% respectively. Nineteen patients (51.35%) died on the operating table; including 6 at induction, 18 patients died postoperatively (48.65%). Deaths were related to the evolution of the patient's pathology in 70.27% (n = 26), to surgery in 16.22% (n = 6) and anesthesia in 13.51% (n = 5).
Conclusion: Death audit reveals multiple and varied causes, the improvement of this situation requires training and equipping our hospitals with suitable materials and consumables.