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The need for a universal method of quantifying severity of illness to allow accurate analysis of the results of treatment in neonatal surgical cases

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Abstract

Clinical audits must be based on good data and what is being reported must be clearly defined. Severity-of-illness scores (SOI) have been developed for newborns and neonates; neonatal surgical case reviews have to be stratified in this manner in the future. This assessment addresses risk to life (predicted mortality) estimated at the point immediately before surgical treatment. General neonatal cases are divided into group A: primary problem medical, complications require surgery; and group B: major malformations that require surgery. Risk categories are established using NTISS scores for group A patients. A new scoring method still to be validated is used in group B. The applicability of the suggested methods are tested using 50 patients with necrotising enterocolitis (group A) and 50 with oesophageal atresia/tracheo-oesophageal fistula (group B). This, a first attempt at stratifying surgical neonatal cases in this manner, illustrates the importance of refining clinical audits in this way. The further development of neonatal SOI risk scores and the utilisation of such tools in risk assessment in surgical patients is awaited.

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Authors and Affiliations

  1. Division of Paediatric Surgery, 154/28 Johannesburg Hospital, University of the Witwatersrand Medical School, P. Bag X39, 2000, Johannesburg, South Africa

    M. R. Q. Davies

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  1. M. R. Q. Davies
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Davies, M.R.Q. The need for a universal method of quantifying severity of illness to allow accurate analysis of the results of treatment in neonatal surgical cases. Pediatr Surg Int 10, 305–308 (1995). https://doi.org/10.1007/BF00182208

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  • DOI: https://doi.org/10.1007/BF00182208

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