Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit.
Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit.
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DOI：
10.1016/j.jpeds.2021.11.025
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Greenberg RG
中科院分区：
文献类型：
--
作者：
Sanderson KR;Warady B;Carey W;Tolia V;Boynton MH;Benjamin DK;Jackson W;Laughon M;Clark RH;Greenberg RG
确定与在新生儿重症监护室（NICU）接受透析的婴儿死亡率相关的风险因素。在这项回顾性队列研究中，我们从Pediatrix临床数据仓库中提取了1999-2018年在NICU接受透析的所有婴儿的数据。使用具有稳健标准误的考克斯比例风险模型，我们估计了与人口统计学、出生细节、医疗并发症和治疗暴露相关的死亡风险比。我们确定了273名接受透析的婴儿。出生时的中位胎龄为35周（四分位值（IQV）33-37），中位出生体重为2570克（2000-3084），8%小于胎龄，41%为白色，72%为男性。超过一半的婴儿（59%）有肾脏异常; 71名（26%）婴儿在NICU出院前死亡。与透析开始后死亡风险增加相关的因素包括无肾脏畸形、黑人、胎龄<32周、坏死性小肠结肠炎、出生后7天内透析以及接受麻痹剂或血管加压剂（均P <0.05）。在这个在NICU接受透析超过20年的婴儿队列中，超过70%的婴儿存活。无肾脏异常史的婴儿和有与透析开始时疾病严重程度相一致的风险因素的婴儿的死亡概率更高。
To identify risk factors associated with mortality for infants receiving dialysis in the Neonatal Intensive Care Unit (NICU). In this retrospective cohort study, we extracted data from the Pediatrix Clinical Data Warehouse on all infants who received dialysis in the NICU from 1999–2018. Using a Cox proportional hazards model with robust standard errors we estimated the mortality hazard ratios associated with demographics, birth details, medical complications, and treatment exposures. We identified 273 infants who received dialysis. Median gestational age at birth was 35 weeks (interquartile values (IQV) 33–37), and median birth weight was 2570 grams (2000–3084), 8% were small for gestational age, 41% white, and 72% male. Over half of the infants (59%) had a kidney anomaly; 71 (26%) infants died before NICU hospital discharge. Factors associated with increased risk of dying after dialysis initiation included lack of kidney anomalies, Black race, gestational age <32 weeks, necrotizing enterocolitis, dialysis within 7 days of life, and receipt of paralytics or vasopressors (all P < .05). In this cohort of infants who received dialysis in the NICU over two decades, more than 70% of infants survived. The probability of death was greater among infants without a history of a kidney anomaly and those with risk factors consistent with greater severity of illness at dialysis initiation.
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DOI：
10.1016/s2352-4642(17)30069-x
发表时间：
2017-11
期刊：
The Lancet. Child & adolescent health
影响因子：
--
作者：
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Neonatal Kidney Collaborative (NKC)
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发表时间：
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期刊：
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PENUT Trial Consortium
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10.1016/j.jpeds.2020.08.035
发表时间：
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期刊：
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影响因子：
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作者：
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影响因子：
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作者：
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作者：
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