新生儿肺炎病死率的预测因素：INCLEN 儿童肺炎研究。
Predictors of Mortality in Neonatal Pneumonia: An INCLEN Childhood Pneumonia Study.
机构信息
Department of Pediatrics, Institute of Child Health, Niloufer Hospital, Osmania Medical College, Hyderabad, Telangana.
Department of Neonatology, Paramitha and NeoBBC Children Hospital, Hyderabad, Telangana. Correspondence to: Dr Sreeram Subramanian, Neonatologist, Paramitha and NeoBBC Children Hospital, Hyderabad, Telangana.
出版信息
Indian Pediatr. 2021 Nov 15;58(11):1040-1045.
BACKGROUND
Neonatal pneumonia contributes significantly to mortality due to pneumonia in the under-five age group, but the predictors of mortality are largely unknown.
OBJECTIVES
To evaluate the clinical and microbiological characteristics and other risk factors that predict mortality in neonates admitted with pneumonia in tertiary care centres.
STUDY DESIGN
Prospective observational cohort study.
PARTICIPANTS
Term and preterm (32 weeks to 36 6/7 weeks) neonates (<28 days of life) admitted with clinical and radiological features suggestive of pneumonia.
INTERVENTION
Baseline sociodemographic data, clinical details, blood culture and nasopharyngeal swabs for virologic assay (RT PCR for RSV, Influenza) were collected at admission and the neonates were observed throughout their hospital stay.
OUTCOME
The primary outcome was predictors of mortality in neonatal pneumonia.
RESULTS
Five hundred neonates were enrolled in the study. Out of 476 neonates with known outcomes, 39 (8.2%) died. On multivariate analysis, blood culture positive sepsis was independently associated with mortality (adjusted OR 2.51, 95% CI1.23 to 5.11; P-0.01).
CONCLUSIONS
Neonates with blood culture positive pneumonia positive are at a higher risk of death.
背景
新生儿肺炎是导致五岁以下儿童肺炎死亡的主要原因，但死亡率的预测因素在很大程度上尚不清楚。
目的
评估在三级保健中心因肺炎住院的新生儿的临床和微生物学特征及其他预测死亡的危险因素。
研究设计
前瞻性观察队列研究。
参与者
足月和早产（32 周至 36 6/7 周）新生儿（<28 天），具有肺炎的临床和影像学特征。
干预措施
在入院时收集基线社会人口统计学数据、临床详细信息、血培养和鼻咽拭子进行病毒学检测（RSV、流感的 RT-PCR），并在整个住院期间观察新生儿。
结局
主要结局是新生儿肺炎死亡的预测因素。
结果
本研究共纳入 500 例新生儿。在已知结局的 476 例新生儿中，有 39 例（8.2%）死亡。多变量分析显示，血培养阳性败血症与死亡率独立相关（调整后的 OR 2.51，95%CI1.23 至 5.11；P=0.01）。
结论
血培养阳性肺炎的新生儿死亡风险更高。
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