Incidence of postoperative respiratory adverse events and its predictors among pediatric surgical patients at Hawassa University Comprehensive Specialized Hospital: A prospective follow-up study

Tesfaye Asefa Hordofa¹Adisu Negesa Tuna²Mulualem Bunare Bussa³Kirubel Tinsae Waqayo⁴Wudinesh Tamiru Bariso⁴Gudeta Teku Ayano⁴Dugo Angasa⁴Kurabachew Mengistu⁴Oliyad Eshetu Adare⁴Mengistu Yinges Kebede⁴Tajera Tageza Ilala^4*

• ¹Anesthesia Department, College of Medicine and Health Science, Madda Walabu University, Goba, Oromia, Ethiopia, Goba, Ethiopia
• ²Anesthesia Department, Institute of Health, Bule Hora University, Bule Hora, Oromia, Ethiopia, Bule Hora, Ethiopia
• ³School of Anesthesia, Wolaita Sodo University, wolaita Sodo, Ethiopia, Sodo, Ethiopia
• ⁴Department of Anesthesia, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia

Background: Postoperative respiratory adverse events (PRAEs) are impairments in the normal functions of respiration resulting from the patient's condition, anesthesia, and surgery. It may associated with postoperative complications such as cardiorespiratory arrest, extended hospital stays, and increased morbidity and mortality. Hence, we aimed to assess the incidence of postoperative respiratory adverse events and its predictors among pediatric surgical patients at Hawassa University Comprehensive Specialized Hospital (HUCSH) in 2024.A prospective follow-up study was conducted using simple random sampling of 205 pediatric patients (aged 0-15 years). Data were collected using a structured questionnaire and analyzed by SPSS, version 26. Categorical data were analyzed using x 2 -test and continuous data were analyzed by independent sample t-test. Multivariable regression was conducted to identify the independent predictors of postoperative respiratory adverse events. The Adjusted Odds Ratio (AOR) and 95% confidence interval (CI) were used to measure the strength of association and statistical significance at a p-value < 0.05.The incidence of postoperative respiratory adverse events was 35.6% among 205 participants. Age less than 1 month (AOR: 9.1, 95% CI: 1.3-12.5), age 1 month-2 years (AOR: 3.6, 95% CI: 5.8-16.1), upper respiratory tract infections (AOR: 3.2, 95% CI: 1.4-9.93), intraoperative opioid analgesics (AOR: 2.53, 95% CI: 1.2-5.97), use of cuffed endotracheal tube (AOR: 3.97, 95% CI: 1.4-11.6), and spontaneous ventilation techniques (AOR: 8.53, 95% CI: 2.9-24.9) were independent predictors of postoperative respiratory adverse events.The incidence of postoperative respiratory events was high. Age less than 2 years, upper respiratory tract infections, intraoperative opioid use, use of cuffed endotracheal tubes, and spontaneous ventilation techniques were independent predictors of postoperative respiratory adverse events. Proper preoperative optimization, avoiding cuffed endotracheal tube (for infants < 2 years), implementing multimodal analgesia, and the use of controlled ventilation may reduce the incidence of postoperative respiratory adverse events.