Torborg, Alexandra M.Cronje, LarissaThomas, Jennifer M.Meyer, H.Bhettay, A.Z.Diedericks, JohanCilliers, CharlKluyts, Hyla-LouiseMrara, BusisiweKalipa, Mandisa N.Rodseth, Reitze N.Biccard, Bruce McIureAllopi, K.Singh, UshaDiyelela-Ndwandwa, P.Nongqo, N.Ravid, B.Anamourlis, P.Coetzee, G.Dlamini, M.Foster, C.Mogane, P.Nel, D.Oosthuizen, A.Redford, L.Murray, R.Basson, C.Joubert, J.Tshifularo, N.Els, T.Orrock, J.Muthambi, M.Matebesi, T.Tshukudu, G.Maela, D.Allorto, N.Bertie, J.Bishop, D.Chetty, K.Grobbelaar, M.Wise, R.Von Steiger, I.Nundlal, P.Garoufalias, E.Westcott, G.Davids, J.Rajah, C.Cairns, C.Mzoneli, Y.Bhagwan, K.Cloete, E.Jaworska, M.Semenya, E.Porrill, O.Mungar, R.Seonandan, P.Perumal, N.Alphonsus, C.Bosman, M.De Castro, A.Drummond, L.Du Bruyn, M.Govender, P.Hardcastle, T.Hlangu, Z.Jeena, P.Mbuyisa, M.Naidu, T.Sewlall, J.Taylor, J.Timakia, K.Van der Walt, W.Biyase, T.Khumalo, Z.Kusel, B.Mukama, I.Ramburuth, M.Singaram, S.Mbeki, M.Schutte, H.Anderson, P.Dorasamy, B.Kint, P.Goga, S.Cronjé, L.Dube, N.Jithoo, S.Naidoo, L.Naidu, L.Reddy, T.Saman, Y.Rungan, D.Naidoo, K.Kabambi, K.Mgoqo, N.Mofoka, M.Usenbo, A.Chiu, C.Machere, N.Maiwald, D.Davies, G.Serdyn, T.Gokal, P.Dhanjee, N.Wege, M.Govender, S.Tarr, S.Moodley, M.Balkisson, M.Maharaj, A.Ngcobo, S.Rorke, N.Sikhakhane, S.Khumalo, M.Ramsamy, T.Kabongo, K.Kuhn, W.Matos-Puig, R.Naidoo, R.Thotharam, A.Chohan, A.Adam, S.Appel, I.Burke, A.De Vos, C.Gautam, S.Joubert, E.Rautenbach, R.Roytowski, D.Szpytko, A.Brits, E.Diedericks, BiancaNaude, G.Van Niekerk, J.Fullerton, Z.2019-01-302019-02Torborg, A., Cronje, L., Thomas, J. et al. 2019, 'South African Paediatric Surgical Outcomes Study: a 14-day prospective, observational cohort study of paediatric surgical patients', British Journal of Anaesthesia, vol. 122, no. 2, pp. 224-232.0007-0912 (print)1471-6771 (online)10.1016/j.bja.2018.11.015http://hdl.handle.net/2263/68304BACKGROUND : Children comprise a large proportion of the population in sub-Saharan Africa. The burden of paediatric surgical disease exceeds available resources in Africa, potentially increasing morbidity and mortality. There are few prospective paediatric perioperative outcomes studies, especially in low- and middle-income countries (LMICs). METHODS : We conducted a 14-day multicentre, prospective, observational cohort study of paediatric patients (aged <16 yrs) undergoing surgery in 43 government-funded hospitals in South Africa. The primary outcome was the incidence of in-hospital postoperative complications. RESULTS : We recruited 2024 patients at 43 hospitals. The overall incidence of postoperative complications was 9.7% [95% confidence interval (CI): 8.4–11.0]. The most common postoperative complications were infective (7.3%; 95% CI: 6.2–8.4%). In-hospital mortality rate was 1.1% (95% CI: 0.6–1.5), of which nine of the deaths (41%) were in ASA physical status 1 and 2 patients. The preoperative risk factors independently associated with postoperative complications were ASA physcial status, urgency of surgery, severity of surgery, and an infective indication for surgery. CONCLUSIONS : The risk factors, frequency, and type of complications after paediatric surgery differ between LMICs and high-income countries. The in-hospital mortality is 10 times greater than in high-income countries. These findings should be used to develop strategies to improve paediatric surgical outcomes in LMICs, and support the need for larger prospective, observational paediatric surgical outcomes research in LMICs. CLINICAL TRIAL REGISTRATION : NCT03367832.en© 2018 Elsevier Inc. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in British Journal of Anaesthesia. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. A definitive version was subsequently published in British Journal of Anaesthesia, vol. 122, no. 2, pp. 224-232, 2019. doi : 10.1016/j.bja.2018.11.015.AnesthesiologyDeveloping countriesStatisticsNumerical dataHospital mortalityOutcome assessment (healthcare)PediatricsPostoperative complicationsProspective studiesSpecialtiesSurgicalLow- and middle-income countries (LMICs)Health sciences articles SDG-03SDG-03: Good health and well-beingHealth sciences articles SDG-11SDG-11: Sustainable cities and communitiesPostprint Article