Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study
Main Author: | |
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Publication Date: | 2020 |
Other Authors: | , , |
Format: | Article |
Language: | eng |
Source: | Revista da Associação Médica Brasileira (Online) |
Download full: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901252 |
Summary: | SUMMARY OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood culture |
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Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort studyInfant mortalityCongenital abnormalities/surgeryIntensive care units, neonatalSUMMARY OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood cultureAssociação Médica Brasileira2020-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901252Revista da Associação Médica Brasileira v.66 n.9 2020reponame:Revista da Associação Médica Brasileira (Online)instname:Associação Médica Brasileira (AMB)instacron:AMB10.1590/1806-9282.66.9.1252info:eu-repo/semantics/openAccessOliva-Costa,SofiaNahass,SamirDourado,AndréaLopes,Selmaeng2020-11-04T00:00:00Zoai:scielo:S0104-42302020000901252Revistahttps://ramb.amb.org.br/ultimas-edicoes/#https://old.scielo.br/oai/scielo-oai.php||ramb@amb.org.br1806-92820104-4230opendoar:2020-11-04T00:00Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB)false |
dc.title.none.fl_str_mv |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study |
title |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study |
spellingShingle |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study Oliva-Costa,Sofia Infant mortality Congenital abnormalities/surgery Intensive care units, neonatal |
title_short |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study |
title_full |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study |
title_fullStr |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study |
title_full_unstemmed |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study |
title_sort |
Morbidity and mortality due to surgical congenital malformations from the perspective of surgical neonatal ICU outside a maternity service: a retrospective cohort study |
author |
Oliva-Costa,Sofia |
author_facet |
Oliva-Costa,Sofia Nahass,Samir Dourado,Andréa Lopes,Selma |
author_role |
author |
author2 |
Nahass,Samir Dourado,Andréa Lopes,Selma |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Oliva-Costa,Sofia Nahass,Samir Dourado,Andréa Lopes,Selma |
dc.subject.por.fl_str_mv |
Infant mortality Congenital abnormalities/surgery Intensive care units, neonatal |
topic |
Infant mortality Congenital abnormalities/surgery Intensive care units, neonatal |
description |
SUMMARY OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood culture |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901252 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302020000901252 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1806-9282.66.9.1252 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Médica Brasileira |
publisher.none.fl_str_mv |
Associação Médica Brasileira |
dc.source.none.fl_str_mv |
Revista da Associação Médica Brasileira v.66 n.9 2020 reponame:Revista da Associação Médica Brasileira (Online) instname:Associação Médica Brasileira (AMB) instacron:AMB |
instname_str |
Associação Médica Brasileira (AMB) |
instacron_str |
AMB |
institution |
AMB |
reponame_str |
Revista da Associação Médica Brasileira (Online) |
collection |
Revista da Associação Médica Brasileira (Online) |
repository.name.fl_str_mv |
Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB) |
repository.mail.fl_str_mv |
||ramb@amb.org.br |
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1754212835249881088 |