Acta clinica Croatica, Vol. 58. No. 3., 2019.
Izvorni znanstveni članak
https://doi.org/10.20471/acc.2019.58.03.07
Survival until Discharge of Very-Low-Birth-Weight Infants in Two Croatian Perinatal Care Regions: A Retrospective Cohort Study of Time and Cause of Death
Darjan Kardum
; Neonatal Intensive Care Unit, Department of Pediatrics, Osijek University Hospital Centre, Osijek, Croatia; School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
Boris Filipović-Grčić
; Neonatal Intensive Care Unit, Department of Pediatrics, Zagreb University Hospital Centre, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Andrijana Müller
; School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia; Department of Gynecology and Obstetrics, Osijek University Hospital Centre, Osijek, Croatia
Sandro Dessardo
; Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, Rijeka University Hospital Centre, Rijeka, Croatia; School of Medicine, University of Rijeka, Rijeka, Croatia
Sažetak
We investigated mortality, causes, timing and risk factors for death until hospital discharge in very-low-birth-weight (VLBW) infants born in two Croatian perinatal care regions. This retrospective study included 252 live born VLBW infants. The mortality rate until hospital discharge was 30.5% (77/252). VLBW in-fants who died had by 4 weeks lower gestational age (GA) than surviving infants (median GA, 25 vs. 29 weeks), lower birth weight (BW) (mean BW, 756.4 vs. 1126.4 g), lower 5-minute Apgar score (median 5 vs. 8) and were more often resuscitated at birth (41.6 vs. 19.4%; p<0.001 all). Infants who survived were more often small-for-gestational age (SGA) (28.0 vs. 15.6%; p=0.04) and more often received continuous-positive-airway-pressure (CPAP) in delivery room (13.1 vs. 2.6%; p=0.01). Multivariate logistic regression revealed that parameters influencing death until hospital discharge were 5-minute Apgar score (OR 0.780, 95% CI 0.648-0.939) and higher Clinical Risk Index for Babies (CRIB) score (OR 1.677, 95% CI 1.456-1.931). ROC analysis showed that CRIB score (AUC 0.927, sensitivity 92.2, specificity 81.1; p<0.001) was the strongest predictor of death until hospital discharge. In infants who died within 12 hours, death was most commonly attributed to immaturity and in those surviving >12 hours to necrotizing enterocolitis.
Ključne riječi
Infant, very low birth weight; Cause of death; Hospital mortality; Croatia
Hrčak ID:
230176
URI
Datum izdavanja:
1.9.2019.
Posjeta: 2.077 *