Treatment outcome and associated factors of infantile hypertrophic pyloric stenosis at eastern Ethiopia public hospitals

埃塞俄比亚东部公立医院婴儿肥厚性幽门狭窄的治疗结果及相关因素

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Abstract

BACKGROUND: Infantile hypertrophic pyloric stenosis (IHPS) is a condition whose etiology is not clear, but it is characterized by progressive hypertrophy of the circular muscles of the pylorus with consequent obstruction of the gastric outflow, mostly in neonates and infants under the age of one year. OBJECTIVES: To assess the treatment outcome and associated factors of infantile pyloric sphincter stenosis among paediatric patients admitted to HFCSUH and JUSHYRH. METHODOLOGY: A retrospective patient record review with 78 participants was studied consecutively using a structured questionnaire. The data was processed and analyzed using Epi Info 7 and SPSS version 24. Descriptive analysis was done, and then associated factors to the outcome were assessed using logistic regression analysis. The association's significance was determined using an odds ratio with a 95% confidence interval and a P-value less than 0.05. The study period was from November 1st to 30th, 2022. RESULTS: The magnitude of unfavorable IHPS was 17.1% with a 95% confidence interval of 16.7-23.9%. Hypokalemia (AOR = 2.3, CI = 3.015-19.54), severe dehydration (AOR = 30.9, CI = 2.89-31.75), and delayed presentation (AOR = 7.37, CI = 2.761-12.08) were independent predictors. CONCLUSIONS: The study found a highly unfavorable treatment outcome with delayed presentation; dehydration and electrolyte disturbance were the main predictors of poor outcome. It is recommended to increase community awareness about non-bilious vomiting in infants and ensure high suspicion among healthcare providers. Moreover, following guidelines to correct fluid and electrolyte disturbances and managing these patients in the pediatric ICU postoperatively.

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