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Thirty day mortality after neonatal laparotomy in a Chinese tertiary hospital. BACKGROUND: No data are available on the prevalence of mortality in neonates after major surgery such as laparotomy in China. METHODS: In a tertiary general hospital, 142 newborns who underwent laparotomy for a variety of surgical conditions in the past 6 years were included in this study in Beijing, China. Pre-, intra-, and postoperative variables potentially predictive of postoperative 30 day mortality were collected and compared between the surviving and deceased newborns. RESULTS: Death ≤30 days after laparotomy occurred in 19 of 142 newborns (13.4%) during the study period. Newborns diagnosed with necrotizing enterocolitis (NEC) had the worst outcome (OR, 11.4). Significantly more neonates in the 30 day death group were intubated preoperatively (52.6%) compared with the survival group (19.5%; OR, 10.0). Base excess ≤-10 mmol/L immediately after laparotomy was associated with negative prognosis in the early postoperative period (OR, 11.2). CONCLUSION: The mortality rate of newborns ≤30 days after laparotomy was 13.4% in a Chinese tertiary general hospital in the past 6 years. The factors associated with early death were NEC, preoperative intubation with mechanical ventilation, and postoperative immediate base excess ≤-10 mmol/L.