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早发型败血症在全国极低出生体重儿队列中的结局。

Outcome of early-onset sepsis in a national cohort of very low birth weight infants.

机构信息

Department of Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan St, Petah Tiqva 49202, Israel.

出版信息

Pediatrics. 2010 Apr;125(4):e736-40. doi: 10.1542/peds.2009-2017. Epub 2010 Mar 15.

Abstract

BACKGROUND

Early-onset sepsis (EOS) is associated with significant morbidity and mortality among infants with a very low birth weight (VLBW); however, there is a sparse amount of complete data on large cohorts.

OBJECTIVE

To evaluate the mortality and major morbidities among VLBW infants with EOS.

METHODS

This was a population-based observational study. Data were prospectively collected by the Israel Neonatal Network on all VLBW infants born in Israel from 1995 through 2005. Univariate and multivariable analyses were performed to assess the independent association of EOS on morbidity and mortality of VLBW infants.

RESULTS

The study cohort included 15 839 infants, of whom 383 (2.4%) developed EOS. EOS was associated with significantly increased odds for mortality (odds ratio [OR]: 2.57 [95% confidence interval (CI): 1.97-3.35]), severe intraventricular hemorrhage (OR: 2.24 [95% CI: 1.67-3.00]), severe retinopathy of prematurity (OR: 2.04 [95% CI: 1.32-3.16]), and bronchopulmonary dysplasia (OR: 1.74 [95% CI: 1.24-2.43]). EOS was associated with an increased risk of death and/or severe neurologic morbidity (OR: 2.92 [95% CI: 2.27-3.80]).

CONCLUSIONS

Although only 2.4% of VLBW infants had an episode of EOS, these infants were at an approximately threefold excess risk of death or major neurologic morbidities.

摘要

背景

早发型败血症(EOS)与极低出生体重儿(VLBW)的发病率和死亡率密切相关,但对于大型队列的完整数据,目前数据仍十分有限。

目的

评估患有 EOS 的 VLBW 婴儿的死亡率和主要并发症。

方法

这是一项基于人群的观察性研究。以色列新生儿网络前瞻性收集了 1995 年至 2005 年间在以色列出生的所有 VLBW 婴儿的数据。通过单变量和多变量分析评估 EOS 对 VLBW 婴儿发病率和死亡率的独立影响。

结果

研究队列包括 15839 名婴儿,其中 383 名(2.4%)患有 EOS。EOS 与死亡率显著增加相关(比值比 [OR]:2.57 [95%置信区间 (CI):1.97-3.35])、严重脑室出血(OR:2.24 [95% CI:1.67-3.00])、严重早产儿视网膜病变(OR:2.04 [95% CI:1.32-3.16])和支气管肺发育不良(OR:1.74 [95% CI:1.24-2.43])。EOS 与死亡和/或严重神经系统并发症的风险增加相关(OR:2.92 [95% CI:2.27-3.80])。

结论

尽管只有 2.4% 的 VLBW 婴儿发生了 EOS,但这些婴儿的死亡或主要神经系统并发症的风险增加了约三倍。

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