Contribution of Concurrent Comorbidities to Sepsis-Related Mortality in Preterm Infants ≤32 Weeks of Gestation at an Academic Neonatal Intensive Care Network.
Contribution of Concurrent Comorbidities to Sepsis-Related Mortality in Preterm Infants ≤32 Weeks of Gestation at an Academic Neonatal Intensive Care Network.
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DOI：
10.1055/a-1675-2899
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发表时间：
2024-01
影响因子：
2
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中科院分区：
文献类型：
--
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这项研究试图确定妊娠32周的早产儿并发主要合并症，这些合并症可能与新生儿时期(≤28天生命)内菌血症或血培养阴性败血症的诊断后败血症相关死亡有关。本文是对2012年1月1日至2015年12月31日期间在多个新生儿重症监护病房组成的单一学术网络中收治的32周妊娠≤婴儿的回顾图表，以确定那些被诊断为菌血症或血培养阴性败血症的婴儿的主要原因(S)和死亡时间。对早发性脓毒症(EOS；≤72小时)和迟发性脓毒症(LOS；>；72小时)进行了直接比较。在我们的研究队列中，939例妊娠32周的患者中，182名婴儿被诊断出198次脓毒症，其中7.7%(14/182)死亡。≤。有菌血症或血培养阴性败血症的新生儿死亡率(每组7/14)与诊断为EOS和LOS的新生儿(6/14比8/14)之间没有显著差异。近80%(11/14)的婴儿在死亡前过渡到舒适护理，继而被诊断为严重的3级或4级脑室出血、脑室周围白质软化、坏死性小肠结肠炎和/或肠穿孔。在我们的患者队列中，先前存在的通常与极端早产相关的合并症导致了败血症相关的死亡率。
This study sought to identify concurrent major comorbidities in preterm infants ≤ 32 weeks of gestation that may have contributed to sepsis-related mortality following a diagnosis of bacteremia or blood culture-negative sepsis within the neonatal period (≤28 days of life). This is a retrospective chart review of infants ≤ 32 weeks of gestation, who were admitted to a single academic network of multiple neonatal intensive care units between January 1, 2012 and December 31, 2015, to determine the primary cause(s) and timing of death in those diagnosed with bacteremia or blood culture-negative sepsis. Direct comparisons between early-onset sepsis (EOS; ≤ 72 hours) and late-onset sepsis (LOS; > 72 hours) were made. In our study cohort of 939 total patients ≤ 32 weeks of gestation, 182 infants were diagnosed with 198 episodes of sepsis and 7.7% (14/182) died. Mortality rates did not significantly differ between neonates with bacteremia or blood culture-negative sepsis (7/14 each group), and those diagnosed with EOS compared with LOS (6/14 vs. 8/14). Nearly 80% (11/14) of infants were transitioned to comfort care prior to their death secondary to a coinciding diagnosis of severe grade 3 or 4 intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, and/or intestinal perforation. Pre-existing comorbidities commonly associated with extreme preterm birth contributed to sepsis-related mortality in our patient cohort.
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Madhi, Shabir A.
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