加利福尼亚州新生儿转运期间的临床恶化。
Clinical deterioration during neonatal transport in California.
机构信息
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
California Perinatal Quality Care Collaborative, Stanford, CA, USA.
出版信息
J Perinatol. 2020 Mar;40(3):377-384. doi: 10.1038/s41372-019-0488-5. Epub 2019 Sep 5.
OBJECTIVE
Identify clinical factors, transport characteristics and transport time intervals associated with clinical deterioration during neonatal transport in California.
STUDY DESIGN
Population-based database was used to evaluate 47,794 infants transported before 7 days after birth from 2007 to 2016. Log binomial regression was used to estimate relative risks.
RESULTS
30.8% of infants had clinical deterioration. Clinical deterioration was associated with prematurity, delivery room resuscitation, severe birth defects, emergent transports, transports by helicopter and requests for delivery room attendance. When evaluating transport time intervals, time required for evaluation by the transport team was associated with increased risk of clinical deterioration. Modifiable transport intervals were not associated with increased risk.
CONCLUSION
Our results suggest that high-risk infants are more likely to be unstable during transport. Coordination and timing of neonatal transport in California appears to be effective and does not seem to contribute to clinical deterioration despite variation in the duration of these processes.
目的
确定加利福尼亚州新生儿转运过程中与临床恶化相关的临床因素、转运特征和转运时间间隔。
研究设计
利用基于人群的数据库评估了 2007 年至 2016 年间出生后 7 天内转运的 47794 名婴儿。采用对数二项式回归估计相对风险。
结果
30.8%的婴儿出现临床恶化。临床恶化与早产、产房复苏、严重出生缺陷、紧急转运、直升机转运和要求产房到场有关。在评估转运时间间隔时，转运团队评估所需的时间与临床恶化的风险增加相关。可改变的转运间隔与风险增加无关。
结论
我们的结果表明，高危婴儿在转运过程中更有可能不稳定。加利福尼亚州的新生儿转运协调和时间似乎是有效的，尽管这些过程的持续时间存在差异，但似乎不会导致临床恶化。
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