Neonatal near miss: a systematic review
Neonatal near miss: a systematic review
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DOI：
10.1186/s12884-015-0758-y
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发表时间：
2015-12-01
影响因子：
3.1
通讯作者：
Cecatti, Jose G.
中科院分区：
文献类型：
--
作者：
Santos, Juliana P.;Pileggi-Castro, Cynthia;Cecatti, Jose G.
背景：新生儿未命中的概念已经被提出作为评估遭受任何生命威胁的新生儿的护理质量的一种工具。然而，目前还没有国际公认的概念或标准来定义或识别新生儿近距离死亡。本研究的目的是对能够识别新生儿险些死亡病例和预测新生儿死亡率的研究和标志物进行系统综述。方法：在Medline、Embase和Scielo数据库中进行电子搜索，没有时间或语言限制，直到2014年12月。术语“新生儿未命中”单独使用或与与新生儿发病率/死亡率和新生儿严重程度评分有关的术语结合使用。研究选择标准分为文章标题、文章摘要、文章全文三个步骤。两名研究人员独立进行研究选择和数据提取。研究结果的异质性不允许进行Meta分析。结果：按照纳入和排除标准，只有4篇文章被纳入。在所有研究中，早产儿和围产期窒息被用作近距离遗漏标记。提取或估计关于新生儿发病率和死亡率的健康指标。新生儿险情发生率是新生儿死亡率的2.6~8倍。结论：务实的管理标准有助于新生儿险情概念的形成。根据这些标准确定最严重的病例并预测死亡率。此外，险些未命中的概念可用作评估新生儿护理的工具。这是制定减少死亡率和长期后遗症的管理战略的第一步。
Background: The concept of neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there are no internationally agreed concepts or criteria for defining or identifying neonatal near miss. The purpose of this study was to perform a systematic review of studies and markers that are able to identify neonatal near miss cases and predict neonatal mortality.Methods: Electronic searches were performed in the Medline, Embase and Scielo databases, with no time or language restriction, until December 2014. The term "neonatal near miss" was used alone or in combination with terms related to neonatal morbidity/mortality and neonatal severity scores. Study selection criteria involved three steps: title, abstract and full text of the articles. Two researchers performed study selection and data extraction independently. Heterogeneity of study results did not permit the performance of meta-analysis.Results: Following the inclusion and exclusion criteria adopted, only four articles were selected. Preterm and perinatal asphyxia were used as near miss markers in all studies. Health indicators on neonatal morbidity and mortality were extracted or estimated. The neonatal near miss rate was 2.6 to 8 times higher than the neonatal mortality rate.Conclusions: Pragmatic and management criteria are used to help develop the neonatal near miss concept. The most severe cases are identified and mortality is predicted with these criteria. Furthermore, the near miss concept can be used as a tool for evaluating neonatal care. It is the first step in building management strategies to reduce mortality and long-term sequelae.