Missed Congenital Heart Disease in Neonates
Missed Congenital Heart Disease in Neonates
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DOI：
10.1111/j.1747-0803.2010.00418.x
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发表时间：
2010-05-01
影响因子：
0.3
通讯作者：
Hokanson, John
中科院分区：
文献类型：
--
作者：
Ng, Benton;Hokanson, John
目标。本研究的目的是确定威斯康星州新生儿漏诊先天性心脏病导致出生后 2 周内死亡或再入院的发生率。设计。对 2002 年至 2006 年威斯康星州的住院和死亡记录进行了审查。仅考虑那些出生后出院回家且没有心脏或主要非心脏诊断的新生儿。威斯康星州医院记录使用国际疾病分类第九版 (ICD-9) 代码识别出那些在出生后前 2 周内重新入院并诊断为心脏病的新生儿。威斯康星州的死亡记录还确定了在出生后 14 天内死亡的患者，这些患者使用国际疾病分类第十版修订版 (ICD-10) 代码诊断为心脏病。如果诊断为左侧阻塞性病变或紫绀性心脏缺陷，则不良事件归因于先天性心脏病。如果没有其他主要诊断并且数据表明有治疗意图，则其他不良事件可归因于心脏病。威斯康星州的 114 家医院在 2002 年至 2006 年期间接生了 340 203 名婴儿，根据接生总数将其分为四分位数，以确定根据医院出生人数的不同，漏诊先天性心脏病的发生率是否存在差异。结果。 2002 年至 2006 年间，威斯康星州的 345 573 名新生儿中，有 14 名 (1: 24 684) 因先天性心脏病在出生后最初 2 周内死亡或再次住院。主动脉缩窄和左心发育不全综合征是最常见的诊断。根据在分娩医院进行的分娩次数，先天性心脏病的漏诊率似乎没有差异。结论。 2002 年至 2006 年间，威斯康星州有 1:24 684 名新生儿因先天性心脏病漏诊而导致 2 周龄以下新生儿死亡或再入院事件。严重的左侧阻塞性病变是这些事件的最常见原因。
Objectives. The purpose of this study was to determine the incidence of missed congenital heart disease in neonates in the state of Wisconsin leading to death or readmission during the first 2 weeks of life.Design. Wisconsin hospitalization and death records were reviewed from 2002 to 2006. Only those neonates discharged home after birth without a cardiac or major non-cardiac diagnosis were considered. Wisconsin hospital records identified those neonates readmitted during the first 2 weeks of life with a diagnosis of heart disease using International Classification of Diseases, 9th Revision (ICD-9) codes. Wisconsin death records also identified patients who died within the first 14 days of life who had a diagnosis of heart disease using International Classification of Diseases, 10th Revision (ICD-10) codes. Adverse events were attributed to congenital heart disease if the diagnosis was a left-sided obstructive lesion or a cyanotic heart defect. Other adverse events were attributed to heart disease if no other major diagnosis was present and the data suggested an intention to treat. The 114 Wisconsin hospitals, which delivered 340 203 babies during 2002-2006, were stratified into quartiles based on the total number of deliveries to determine if there was a difference in incidence of missed congenital heart disease based on hospital birth size.Results. Congenital heart disease led to death or rehospitalization during the first 2 weeks of life in 14 out of 345 573 births (1 : 24 684) in Wisconsin between 2002 and 2006. Coarctation of the aorta and hypoplastic left heart syndrome were the most common diagnoses. There did not appear to be a difference in the incidence of missed diagnosis of congenital heart disease based on the number of deliveries performed at the birth hospital.Conclusions. Death or readmission events in neonates under 2 weeks of age because of a missed diagnosis of congenital heart disease occurred in 1 : 24 684 neonates in the state of Wisconsin between 2002 and 2006. Critical left sided obstructive lesions were the most common cause of these events.