Outcome of Early-Onset Sepsis in a National Cohort of Very Low Birth Weight Infants
Outcome of Early-Onset Sepsis in a National Cohort of Very Low Birth Weight Infants
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DOI：
10.1542/peds.2009-2017
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发表时间：
2010-04-01
期刊：
影响因子：
8
通讯作者：
Reichman, Brian
中科院分区：
文献类型：
--
作者：
Klinger, Gil;Levy, Itzhak;Reichman, Brian
背景：早发性败血症（EOS）与极低出生体重（VLBW）婴儿的高发病率和死亡率相关；然而，关于大样本队列的完整数据较为稀少。
目的：评估患有EOS的VLBW婴儿的死亡率和主要发病率。
方法：这是一项基于人群的观察性研究。以色列新生儿网络前瞻性地收集了1995年至2005年在以色列出生的所有VLBW婴儿的数据。进行了单变量和多变量分析以评估EOS与VLBW婴儿发病率和死亡率的独立关联。
结果：研究队列包括15839名婴儿，其中383名（2.4%）发生了EOS。EOS与死亡几率显著增加相关（比值比[OR]：2.57[95%置信区间（CI）：1.97 - 3.35]）、严重脑室内出血（OR：2.24[95%CI：1.67 - 3.00]）、严重早产儿视网膜病变（OR：2.04[95%CI：1.32 - 3.16]）以及支气管肺发育不良（OR：1.74[95%CI：1.24 - 2.43]）相关。EOS与死亡和/或严重神经系统疾病的风险增加相关（OR：2.92[95%CI：2.27 - 3.80]）。
结论：尽管只有2.4%的VLBW婴儿发生EOS，但这些婴儿死亡或发生主要神经系统疾病的风险大约增加了三倍。《儿科学》2010年；125：e736 - e740
BACKGROUND: Early-onset sepsis (EOS) is associated with significant morbidity and mortality among infants with a very low birth weight (VLBW); however, there is a sparse amount of complete data on large cohorts.OBJECTIVE: To evaluate the mortality and major morbidities among VLBW infants with EOS.METHODS: This was a population-based observational study. Data were prospectively collected by the Israel Neonatal Network on all VLBW infants born in Israel from 1995 through 2005. Univariate and multivariable analyses were performed to assess the independent association of EOS on morbidity and mortality of VLBW infants.RESULTS: The study cohort included 15 839 infants, of whom 383 (2.4%) developed EOS. EOS was associated with significantly increased odds for mortality (odds ratio [OR]: 2.57 [95% confidence interval (CI): 1.97-3.35]), severe intraventricular hemorrhage (OR: 2.24 [95% CI: 1.67-3.00]), severe retinopathy of prematurity (OR: 2.04 [95% CI: 1.32-3.16]), and bronchopulmonary dysplasia (OR: 1.74 [95% CI: 1.24-2.43]). EOS was associated with an increased risk of death and/or severe neurologic morbidity (OR: 2.92 [95% CI: 2.27-3.80]).CONCLUSIONS: Although only 2.4% of VLBW infants had an episode of EOS, these infants were at an approximately threefold excess risk of death or major neurologic morbidities. Pediatrics 2010; 125: e736-e740