The Influence of the Variation in Sepsis Rate between Neonatal Intensive Care Units on Neonatal Outcomes in Very-Low-Birth-Weight Infants
The Influence of the Variation in Sepsis Rate between Neonatal Intensive Care Units on Neonatal Outcomes in Very-Low-Birth-Weight Infants
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DOI：
10.1038/s41598-020-63762-6
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发表时间：
2020-04-21
影响因子：
4.6
通讯作者：
Lee, Jin A.
中科院分区：
文献类型：
--
作者：
Sung, Tae-Jung;Sohn, Jin A.;Lee, Jin A.
脓毒症是众所周知的影响新生儿的结果。我们评估了中心间脓毒症发生率的变异性对极低出生体重儿（VLBWI）结局的影响。2013年至2016年在韩国新生儿网络登记的7，493名VLBWI根据脓毒症发生率分为三组：低脓毒症组（LS）= 75（th）。LS、IS和HS组的脓毒症发生率密度分别为1.17、3.17和8.88例/1，000人-天。在对多个产前和围产期因素进行倾向评分匹配后，HS组的死亡、中度至重度支气管肺发育不良和/或死亡、脑室周围白质软化和无重大疾病生存的比值比为2.0（95%置信区间1.4-2.8），1.9（1.5-2.4）、1.5（1.1-2.3）和0.7（0.5-0.8），与LS组相比分别为2.2（1.6-3.2）、2.3（1.8-2.9）、2.0（1.3-2.9）和0.7（0.6-0.9）。LS组和IS组之间的这些结局无显著差异。因此，在全国范围内提高质量以控制脓毒症发生率，特别是在脓毒症发生率高的单位，将有助于改善VLBWI的结局。
Sepsis is commonly known to affect neonatal outcomes. We assessed how much center-to-center variability of the sepsis rate affects the outcomes of very-low-birth-weight infants (VLBWIs). 7,493 VLBWIs registered in the Korean Neonatal Network from 2013 to 2016 were classified into three groups according to the sepsis rate: low sepsis group (LS)= 75(th). The incidence density of sepsis for the LS, IS, and HS groups were 1.17, 3.17, and 8.88 cases/1,000 person-days. After propensity score matching was done for multiple antenatal and perinatal factors, the odds ratio of death, moderate to severe bronchopulmonary dysplasia and/or death, periventricular leukomalacia, and survival without major morbidities for the HS group were 2.0 (95% confidence interval 1.4-2.8), 1.9 (1.5-2.4), 1.5 (1.1-2.3) and 0.7 (0.5-0.8) when compared with the IS group, and 2.2 (1.6-3.2), 2.3 (1.8-2.9), 2.0 (1.3-2.9), and 0.7 (0.6-0.9) when compared with the LS group. There were no significant differences in those outcomes between the LS and IS groups. Hence, nationwide quality improvements to control the sepsis rate especially in units with a high sepsis rate will be helpful to improve the outcomes of VLBWIs.