論文

査読有り 国際誌
2018年3月

Clinical factors associated with in-hospital death in pediatric surgical patients admitted to the neonatal intensive care unit: a 15-year single tertiary center experience.

Journal of pediatric surgery
  • Kohei Otake
  • ,
  • Keiichi Uchida
  • ,
  • Michiko Kubo
  • ,
  • Akira Yamamoto
  • ,
  • Yuka Nagano
  • ,
  • Ryo Uratani
  • ,
  • Kiyoshi Hashimoto
  • ,
  • Kohei Matsushita
  • ,
  • Mikihiro Inoue
  • ,
  • Hirofumi Sawada
  • ,
  • Masato Kusunoki

53
3
開始ページ
499
終了ページ
502
記述言語
英語
掲載種別
DOI
10.1016/j.jpedsurg.2017.07.007

BACKGROUND/PURPOSE: The purpose of this study was to explore clinical characteristics and primary surgical diagnoses associated with in-hospital death in pediatric surgical patients admitted to the neonatal intensive care unit (NICU) of a tertiary hospital. METHODS: This retrospective study includes all patients admitted to our NICU for pediatric surgical diseases between January 2001 and December 2015. Univariate and multivariate binary logistic regression were performed to assess independent factors associated with in-hospital death. RESULTS: A total of 440 cases were included and 334 (83.5%) patients underwent one or more surgeries. Thirty six patients (8.2%) died while hospitalized in the NICU. The 5 most common surgical diagnoses were intestinal atresia/stenosis, anorectal malformation, congenital diaphragmatic hernia (CDH), esophageal atresia, and urinary system disorder. Necrotizing enterocolitis (NEC) had the highest mortality rate. Using logistic regression, in-hospital death was predicted by extremely low birth weight (ELBW) (odds ratio (OR)=6.594; P=0.006), CDH (OR=13.954; P<0.001), and NEC (OR=8.991; P=0.049). CONCLUSIONS: This study describes CDH, NEC, and ELBW are independent predictive factors associated with in-hospital death of pediatric surgical patients in our NICU. Novel approaches for those conditions are required to improve the survival. TYPE OF STUDY: Prognostic LEVELS OF EVIDENCE: II.

リンク情報
DOI
https://doi.org/10.1016/j.jpedsurg.2017.07.007
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28774507

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