Brasil Danyelle Rodrigues Pinheiro de Araujo, Vilela Mirella Bezerra Rodrigues, França Karla Eveline Ximenes de, Sarinho Silvia Wanick
Universidade Federal de Pernambuco, Recife, PE, Brazil.
Rev Paul Pediatr. 2019 Jul 4;37(3):275-282. doi: 10.1590/1984-0462/;2019;37;3;00011. eCollection 2019.
To characterize near miss neonatal morbidity in tertiary hospitals in a capital city of Northeast Brazil based on Health Information Systems, and to identify differences regarding indicators of near miss cases, allowing the surveillance of newborns with risk of death.
A cross-sectional study carried out in hospitals with neonatal intensive care unit, whose neonatal near miss cases in 2012 were identified from a deterministic linkage between the Mortality Information System and the Live Birth Information System. The biological variables of children, variables related to maternal characteristics and indicators of near miss were calculated by type of service and hospital. Biological variables of children, variables related to maternal characteristics and near miss indicators were calculated by service type and hospital and then compared by ratio difference test, parametric and non-parametric tests for measures of central tendency.
Of 24,254 live births, 2,098 cases of neonatal morbidity near miss were identified, most of them concentrated in the public hospitals (89.9%). The combination of birth weight and gestational age had the largest number of cases in both segments, public (43.5%) and private (46%). Variations in neonatal near miss indicators were observed between hospitals, which suggests assistance problems.
The concept of neonatal near miss, its applicability with data from Health Information Systems, and its indicators are a preliminary tool to monitor hospital care for newborns by signaling health services that require in-depth evaluation and investments for quality improvement.
基于卫生信息系统，对巴西东北部一个首府城市的三级医院中新生儿险些死亡的发病率进行特征描述，并确定险些死亡病例指标之间的差异，以便对有死亡风险的新生儿进行监测。
在设有新生儿重症监护病房的医院开展一项横断面研究，通过死亡信息系统与活产信息系统之间的确定性关联，确定2012年的新生儿险些死亡病例。按服务类型和医院计算儿童的生物学变量、与母亲特征相关的变量以及险些死亡指标。按服务类型和医院计算儿童的生物学变量、与母亲特征相关的变量以及险些死亡指标，然后通过比率差异检验、用于集中趋势测量的参数检验和非参数检验进行比较。
在24254例活产中，确定了2098例新生儿险些死亡病例，其中大多数集中在公立医院（89.9%）。出生体重和孕周的组合在公立（43.5%）和私立（46%）两个部门的病例数最多。各医院之间观察到新生儿险些死亡指标存在差异，这表明存在医疗救助问题。
新生儿险些死亡的概念、其在卫生信息系统数据中的适用性及其指标，是通过标记需要深入评估和投资以提高质量的卫生服务，来监测新生儿医院护理的初步工具。
