Factors associated with mortality in congenital malformations of the gastrointestinal tract in a tertiary center in Senegal

Objective Patients with congenital malformations(CMs)of the gastrointestinal tract(GIT)have a very high mortality.However,the literature on the factors associated with mortality in these patients is scarce in sub-Saharan Africa.The aim of this study is to identify independent risk factors for mortality in patients with CMs of the GIT at our pediatric surgical department.Methods We conducted a retrospective analysis of cases with CMs of the GIT managed at a tertiary center from 2018 to 2021.Patients were subdivided into two groups based on the outcomes,and variables with a significant difference were analyzed by logistic regression.Results Our review included 226 patients,63 of whom died(27.88%).Patient age ranged from 0 to 15 years.Taking into account statistical significance,mortality was more frequent in neonates than in older patients(57.30%vs 6.15%),in patients coming out of the Dakar area than in those from the Dakar area(43.75%vs 19.18%),in patients with abnormal prenatal ultrasound than in those with normal ultrasound(100%vs 26.67%),in premature children than in those born at term(78.57%vs 21.87%),in patients with an additional malformation than in those with an isolated malformation(69.23%vs 25.35%),and in those with intestinal,esophageal,duodenal and colonic atresia than in those with other diagnoses(100%,89%,56.25%and 50%,respectively).Referred patients died more than those who changed hospitals or came from home(55.29%vs 25%and 9.09%,respectively).On multivariable logistic regression,two independent factors of mortality were identified:presence of associated malformation[odds ratio(OR)=13.299;95%Confidence interval(CI)1.370 to 129.137]and diagnosis of esophageal atresia(OR=46.529;95%CI 5.828 to 371.425).Conclusion The presence of an associated malformation or diagnosis of esophageal atresia increases mortality in patients with CMs of the GIT in our environment.