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资源匮乏环境下新生儿败血症的死亡率预测因素。

Predictors of mortality in neonatal septicemia in an underresourced setting.

机构信息

Department of Pediatrics, Olabisi Onabanjo University, Sagamu, Nigeria.

出版信息

J Natl Med Assoc. 2010 Oct;102(10):915-21. doi: 10.1016/s0027-9684(15)30710-0.

Abstract

OBJECTIVE

To determine the predictors of mortality in neonatal septicemia.

METHOD

The records of babies with culture-proven septicemia managed in a Nigerian newborn unit between 2006 and 2008 were studied using bivariate and multivariate analysis.

RESULTS

Out of 174 babies with septicemia, 56 (32.2%) died. Outborn babies, babies with estimated gestational age (EGA) less than 32 weeks, weight less than 1.5 kg, temperature less than 38 degrees C, respiratory distress, abdominal distension, poor skin color, hypoglycemia, and infection with gram-negative pathogens were significantly associated with death by bivariate analysis. Multivariate analysis of these risk factors confirmed that EGA less than 32 weeks (odds ratio [OR], 5.5), respiratory distress (OR, 3.4), abdominal distension (OR, 2.7), poor skin color (OR, 3.3), and hypoglycemia (OR, 5.2) had significant independent contributions to the occurrence of death among babies with culture-proven septicemia.

CONCLUSION

Most of the identified predictors of mortality are modifiable and can be used to draw up a screening tool to determine the clinical severity among septic babies.

摘要

目的

确定新生儿败血症死亡的预测因素。

方法

使用双变量和多变量分析,研究了 2006 年至 2008 年期间在尼日利亚新生儿病房接受培养证实败血症治疗的婴儿的记录。

结果

在 174 例败血症婴儿中,有 56 例(32.2%)死亡。经双变量分析,出生在外的婴儿、估计胎龄(EGA)小于 32 周、体重小于 1.5 公斤、体温低于 38 度、呼吸窘迫、腹部膨隆、皮肤颜色差、低血糖和革兰氏阴性病原体感染与死亡显著相关。对这些危险因素进行多变量分析后证实,EGA 小于 32 周(比值比 [OR],5.5)、呼吸窘迫(OR,3.4)、腹部膨隆(OR,2.7)、皮肤颜色差(OR,3.3)和低血糖(OR,5.2)对培养证实败血症婴儿的死亡发生有显著的独立影响。

结论

大多数确定的死亡预测因素是可以改变的,可以用来制定一个筛选工具,以确定败血症婴儿的临床严重程度。

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