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2021 年,埃塞俄比亚亚的斯亚贝巴公立医院新生儿重症监护病房收治的早产儿的康复时间及预测因素。

Time to recovery and predictors among admitted preterm neonates in the neonatal intensive care units of public hospitals of Addis Ababa, Ethiopia, 2021.

机构信息

College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

BMC Pediatr. 2024 Jul 15;24(1):452. doi: 10.1186/s12887-024-04933-6.

Abstract

INTRODUCTION

Ethiopia implemented measures to reduce preterm mortality, and much is currently being done to avoid preterm death, yet preterm death remains the top cause of infant death. As a result, evaluating median time of recovery and determinants will provide information to planners and policymakers to design strategies to improve preterm survival.

METHODS

Hospital-based retrospective follow-up study was conducted in four selected public hospitals of Addis Ababa from September 2018 to August 2021. Data were collected using a pretested structured questionnaire. Epi-data 4.6 and STATA Version 16 were used for data entry and analysis. Kaplan-Meier survival curve, log-rank test, and median time were computed. To find predictors of time to recovery, a multivariable Cox proportional hazards regression model was fitted, and variables with a p-value less than 0.05 were considered statistically significant.

RESULTS

A total of 466 preterm babies were included in the study of which 261 (56.1%) preterm neonates survived and were discharged from NICUs. The median time to recovery was 10 days (95% CI: 9-12). Low birth weight (Adjusted hazard-ratio [AHR]: 1.91, 95% CI: 1.2-3.06), normal birth weight (AHR: 2.09, 95% CI: 1.16-3.76), late preterm (AHR: 1.91, 95% CI: 1.02-3.55), no hospital-acquired infection (AHR: 2.19, 95% CI: 1.36-3.5), no thrombocytopenia (AHR: 1.96, 95% CI: 1.27-3.02), continuous positive airway pressure (AHR: 0.66, 95% CI: 0.48-0.91), and kangaroo mother care (AHR: 2.04, 95% CI: 1.48-2.81) were found to be independent predictors of time to recovery of preterm babies.

DISCUSSION/CONCLUSION: The recovery rate was found relatively low. Several predictors of preterm recovery time were discovered in the study. The majority of predictors were preventable or treatable. Therefore, emphasis should be given towards prevention and early anticipation, and management of these predictors. Studies to assess the quality of care and cause of low survival rate of preterm infants are recommended.

摘要

引言

埃塞俄比亚采取了措施降低早产儿死亡率,目前为避免早产儿死亡做了很多工作,但早产儿死亡仍然是婴儿死亡的首要原因。因此,评估中位数恢复时间和决定因素将为规划者和决策者提供信息,以制定改善早产儿生存的策略。

方法

本研究为在埃塞俄比亚亚的斯亚贝巴的四家选定公立医院进行的基于医院的回顾性随访研究,时间为 2018 年 9 月至 2021 年 8 月。数据采用经过预测试的结构化问卷收集。使用 Epi-data 4.6 和 STATA 版本 16 进行数据录入和分析。计算 Kaplan-Meier 生存曲线、对数秩检验和中位数时间。为了找到恢复时间的预测因素,拟合了多变量 Cox 比例风险回归模型,并且将 p 值小于 0.05 的变量视为具有统计学意义。

结果

共有 466 名早产儿纳入本研究,其中 261 名(56.1%)早产儿存活并从新生儿重症监护病房出院。中位数恢复时间为 10 天(95%CI:9-12)。低出生体重(调整后的危险比 [AHR]:1.91,95%CI:1.2-3.06)、正常出生体重(AHR:2.09,95%CI:1.16-3.76)、晚期早产儿(AHR:1.91,95%CI:1.02-3.55)、无医院获得性感染(AHR:2.19,95%CI:1.36-3.5)、无血小板减少症(AHR:1.96,95%CI:1.27-3.02)、持续气道正压通气(AHR:0.66,95%CI:0.48-0.91)和袋鼠式母亲护理(AHR:2.04,95%CI:1.48-2.81)被发现是早产儿恢复时间的独立预测因素。

讨论/结论:恢复率发现相对较低。本研究发现了早产儿恢复时间的几个预测因素。大多数预测因素是可预防或可治疗的。因此,应重视预防和早期预测以及这些预测因素的管理。建议进行评估早产儿护理质量和低生存率原因的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d96d/11247717/1b4d137e2764/12887_2024_4933_Fig1_HTML.jpg

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