Predicting death or extended length of stay in infants with congenital diaphragmatic hernia
Predicting death or extended length of stay in infants with congenital diaphragmatic hernia
复制标题
DOI：
10.1038/jp.2016.26
复制
发表时间：
2016-08-01
影响因子：
2.9
通讯作者：
Grover, T. R.
中科院分区：
文献类型：
--
作者：
Murthy, K.;Pallotto, E. K.;Grover, T. R.
目的：预测先天性膈疝（CDH）婴儿的死亡率或住院时间（LOS） 4109天（第90百分位数）。研究设计：我们使用2010 - 2014年儿童医院新生儿数据库进行回顾性分析。在22个参与研究的地区新生儿重症监护病房中，出生bb0 ~ 34周伴有CDH的婴儿被纳入研究对象；入院前已修复或在家的患者被排除在外。主要终点为出院前死亡或住院时间（10109天）。与此结果相关的因素被用来建立一个包含80%队列的多变量方程。对其余20%的婴儿进行验证。结果：该队列（n = 677）的中位妊娠和年龄分别为38周和6小时。主要结局发生在242例（35.7%）婴儿中，分布在死亡率（n = 180,27 %）和LOS （n = 66,10 %）之间。回归分析显示胎龄小（比值比（OR） 2.5, P = 0.008），存在重大出生异常（OR 5.9, P = 0.008）
OBJECTIVE: To predict mortality or length of stay (LOS) 4109 days (90th percentile) among infants with congenital diaphragmatic hernia (CDH).STUDY DESIGN: We conducted a retrospective analysis using the Children's Hospital Neonatal Database during 2010 to 2014. Infants born >34 weeks gestation with CDH admitted at 22 participating regional neonatal intensive care units were included; patients who were repaired or were at home before admission were excluded. The primary outcome was death before discharge or LOS >109 days. Factors associated with this outcome were used to develop a multivariable equation using 80% of the cohort. Validation was performed in the remaining 20% of infants.RESULTS: The median gestation and age at referral in this cohort (n = 677) were 38 weeks and 6 h, respectively. The primary outcome occurred in 242 (35.7%) infants, and was distributed between mortality (n = 180, 27%) and LOS >109 days (n = 66, 10%). Regression analyses showed that small for gestational age (odds ratio (OR) 2.5, P = 0.008), presence of major birth anomalies (OR 5.9, P