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埃塞俄比亚西北部综合专科医院接受光疗的新生儿的恢复时间及其预测因素。

Time to recovery and its predictors among neonates undergone phototherapy at Comprehensive Specialized hospitals of the Northwest Ethiopia.

作者信息

Gedefaw Gezahagn Demsu, Abuhay Abere Gebru, Daka Dawit Tesfaye, Wondie Wubet Tazeb, Gonete Almaz Tefera, Getaneh Fekadeselassie Belege, Endeshaw Yaregal Semanew, Bazezew Astewil Moges, Legesse Bruck Tesfaye, Worku Degalem Tilahun, Ayenew Mulugeta Endalamaw, Abate Asnake Tadesse

机构信息

Department of Neonatal Health Nursing, School of Nursing, College of Medicine and Health Sciences, and Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

Sci Rep. 2024 Dec 30;14(1):31665. doi: 10.1038/s41598-024-80964-4.

Abstract

Phototherapy is the preferred treatment for neonatal hyperbilirubinemia and has largely replaced exchange transfusions due to its effectiveness and safety. The primary aim of this study was to evaluate the time to recovery and its predictors among neonates undergoing phototherapy at the Neonatal Intensive Care Unit of the Northwest Comprehensive Specialized Hospital in Northwest Ethiopia. A multi-center institution-based retrospective follow-up study was conducted among 423 neonates admitted to the neonatal intensive care unit between September 2019 and December 2023, at Comprehensive Specialized Hospitals of Northwest Ethiopia. Simple random sampling techniques were used to select neonates. Data were entered into the EPI Data version 4.6.0.2 and exported to STATA 14 statistical software for analysis. The Kaplan-Meier failure curve was used to estimate the time to recovery from phototherapy. During follow-up, statistical differences between variables were compared using the log-rank test. After testing the goodness of fit of the final model, multi-variable Cox proportional hazard regression was used to identify predictors of recovery time from phototherapy. Variables with a p-value less than 0.05 were considered statistically significant. In total 423 neonates were included in this study. Of these, 68.79% (n = 291) achieved successful clinical recovery, with a median survival time of 3 days. Predictors affecting recovery time were Rh-setup (AHR: 0.63; 95% CI: (0.45-0.86) sepsis (AHR: 0.55; 95% CI: (0.33-0.91), ABO-setup (AHR: 0.59; 95%CI: (0.46-0.79), sex (AHR: 0.70; 95% CI (0.55-0.91), and inadequate feeding (AHR: 0.56; 95% CI: (0.33-0.92) which delayed recovery time. In the current study, the median time to recovery after phototherapy was prolonged compared to as a clinical recommendation. Rh setup, ABO setup, sepsis, poor feeding, and male sex were all predictive factors of delayed recovery time.

摘要

光疗是新生儿高胆红素血症的首选治疗方法,因其有效性和安全性,在很大程度上已取代了换血疗法。本研究的主要目的是评估埃塞俄比亚西北部西北综合专科医院新生儿重症监护病房接受光疗的新生儿的恢复时间及其预测因素。在埃塞俄比亚西北部综合专科医院,对2019年9月至2023年12月期间入住新生儿重症监护病房的423名新生儿进行了一项基于多中心机构的回顾性随访研究。采用简单随机抽样技术选择新生儿。数据录入EPI Data 4.6.0.2版本,并导出到STATA 14统计软件进行分析。采用Kaplan-Meier失败曲线估计光疗恢复时间。随访期间,使用对数秩检验比较变量之间的统计学差异。在检验最终模型的拟合优度后,采用多变量Cox比例风险回归来确定光疗恢复时间的预测因素。p值小于0.05的变量被认为具有统计学意义。本研究共纳入423名新生儿。其中,68.79%(n = 291)实现了临床成功恢复,中位生存时间为3天。影响恢复时间的预测因素有Rh血型系统(风险比:0.63;95%置信区间:(0.45 - 0.86))、败血症(风险比:0.55;95%置信区间:(0.33 - 0.91))、ABO血型系统(风险比:0.59;95%置信区间:(0.46 - 0.79))、性别(风险比:0.70;95%置信区间(0.55 - 0.91))以及喂养不足(风险比:0.56;95%置信区间:(0.33 - 0.92)),这些因素均会延迟恢复时间。在本研究中,与临床建议相比,光疗后的中位恢复时间延长了。Rh血型系统、ABO血型系统、败血症、喂养不良和男性性别均为恢复时间延迟的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c9f/11685931/d7f7405c9496/41598_2024_80964_Fig1_HTML.jpg

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