scholarly journals Ten-year trend of care practices, morbidities and survival of very preterm neonates in the Malaysian National Neonatal Registry: a retrospective cohort study

2021 ◽  
Vol 5 (1) ◽  
pp. e001149
Author(s):  
Nem Yun Boo ◽  
Seok Chiong Chee ◽  
Siew Hong Neoh ◽  
Eric Boon-Kuang Ang ◽  
Ee Lee Ang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neonatal Intensive Care ◽  
Surfactant Therapy ◽  
Preterm Neonates ◽  
Very Preterm ◽  
Increased Risk ◽  
Care Practices

ObjectivesTo determine a 10-year trend of survival, morbidities and care practices, and predictors of in-hospital mortality in very preterm neonates (VPTN, gestation 22 to <32 weeks) in the Malaysian National Neonatal Registry.DesignRetrospective cohort study.Setting43 Malaysian neonatal intensive care units.Patients29 010 VPTN (without major malformations) admitted between 1 January 2009 and 31 December 2018.Main outcome measuresCare practices, survival, admission hypothermia (AH, <36.5°C), late-onset sepsis (LOS), pneumothorax, necrotising enterocolitis grade 2 or 3 (NEC), severe intraventricular haemorrhage (sIVH, grade 3 or 4) and bronchopulmonary dysplasia (BPD).ResultsDuring this 10-year period, there was increased use of antenatal steroid (ANS), lower segment caesarean section (LSCS) and early continuous positive airway pressure (eCPAP); but decreased use of surfactant therapy. Survival had increased from 72% to -83.9%. The following morbidities had decreased: LOS (from 27.9% to 7.1%), pneumothorax (from 6.0% to 2.7%), NEC (from 8.1% to 4.7%) and sIVH (from 12.2% to 7.5%). However, moderately severe AH (32.0°C–35.9°C) and BPD had increased. Multiple logistic regression analyses showed that lower birth weight, no ANS, no LSCS, admission to neonatal intensive care unit with <100 VPTN admissions/year, no surfactant therapy, no eCPAP, moderate and severe AH, LOS, pneumothorax, NEC and sIVH were significant predictors of mortality.ConclusionSurvival and major morbidities had improved modestly. Failure to use ANS, LSCS, eCPAP and surfactant therapy, and failure to prevent AH and LOS increased risk of mortality.

Bacterial colonisation of the endotracheal tube in ventilated very preterm neonates: A retrospective cohort study

2020 ◽  
Vol 56 (10) ◽  
pp. 1607-1612 ◽  
Author(s):  
Jasmine Antoine ◽  
Garry D T Inglis ◽  
Mandy Way ◽  
Peter O'Rourke ◽  
Mark W Davies
Keyword(s):  
Cohort Study ◽  
Endotracheal Tube ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Preterm Neonates ◽  
Bacterial Colonisation ◽  
Very Preterm

scholarly journals The Epidemiology of Respiratory Distress Syndrome in Neonates in Fiji: A Retrospective Cohort Study

2019 ◽  
Vol 2 ◽  
Author(s):  
Joshua Szanyi ◽  
Ilisapeci Tuibeqa ◽  
Tupou Ratu ◽  
Kate Milner ◽  
Cattram D Nguyen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Distress Syndrome ◽  
Clinical Information ◽  
Surfactant Therapy ◽  
Preterm Neonates ◽  
Middle Income

Introduction The commonest cause of death in preterm neonates worldwide is respiratory distress syndrome (RDS). In Fiji, prematurity and RDS have been identified as important causes of neonatal mortality and surfactant was added to supportive care in 2015. This retrospective cohort study describes the RDS epidemiology in Fiji’s major neonatal centre prior to surfactant introduction. Methods RDS-related intensive care admissions in 2013 and 2014 were reviewed and clinical information was extracted from medical records. Subsequent readmissions of RDS cases were also retrieved. Results The rate of RDS was 6.7 (95% confidence interval 5.5 – 8.0) per 1,000 live births. There were 36 RDS deaths. No cases who died received more than one dose of corticosteroids, compared to 25.3% of survivors. Conclusion Death from RDS was high, and is consistent with that in other low- and middle-income countries prior to the uptake of surfactant therapy. Improving antenatal corticosteroid use and access to surfactant therapy is likely to improve outcomes.

scholarly journals Dexmedetomidine-Associated Hyperthermia: A Retrospective Cohort Study of Intensive Care Unit Admissions between 2009 and 2016

2017 ◽  
Vol 45 (6) ◽  
pp. 727-736 ◽  
Author(s):  
K. E. D. Grayson ◽  
A. E. Tobin ◽  
D. T. K. Lim ◽  
D. E. Reid ◽  
M. Ghani
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Increased Risk

Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature ≥39.5°C, including patient characteristics, temporality and potential risk factors. We conducted a retrospective cohort study of all intensive care unit (ICU) admissions between 1 July 2009 and 31 May 2016 in a tertiary ICU in Australia. Temperature data was available for 9,782 ICU admissions. Dexmedetomidine was given intravenously to 611 (6.3%) patients at a dose of 0 to 1.5 g/kg/hour. Temperatures ≥39.5°C were recorded in 341 (3.5%) patients. Overall hospital mortality was 10.8% for all admissions and 29.3% for patients with temperatures ≥39.5°C. Dexmedetomidine exposure was more frequent in patients with temperature recordings ≥39.5°C compared to those with temperatures <39.5°C, 11.94% versus 2.94% (odds ratio [OR] 4.49; 95% confidence intervals [CI] 3.37, 5.92; P <0.001). The association was stronger for patients post-open heart surgery (OHS) with temperatures ≥39.5°C (OR 12.9; 95% CI 5.01, 31.62; P <0.001). Multivariate analysis showed an independent association between dexmedetomidine and a temperature ≥39.5°C in two particular patient groups: OHS (OR 2.72; 95% CI 1.1, 6.9; P <0.001), and obesity (OR 3.44; 95% CI 1.5, 7.9; P <0.001). Dexmedetomidine exposure is associated with an increased risk of hyperthermia. Possible risk factors are open heart surgery and obesity.

scholarly journals Effects of a Home-Based Family-Centred Early Habilitation Program on Neurobehavioural Outcomes of Very Preterm Born Infants: A Retrospective Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Michela Poggioli ◽  
Fabrizio Minichilli ◽  
Tiziana Bononi ◽  
Pasquina Meghi ◽  
Paolo Andre ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Infant Development ◽  
Control Group ◽  
Preterm Children ◽  
Very Preterm ◽  
Home Based ◽  
Increased Risk ◽  
Early Developmental

Preterm children have an increased risk of neurodevelopmental impairments which include psychomotor and language retardation. The objectives of the present retrospective cohort study were to examine the effects of an individually adapted, home-based, and family-centred early developmental habilitation program on neurodevelopmental and behavioural outcomes of very preterm children compared with a standard follow-up at 2 years’ corrected age. Enrolled infants were retrospectively assigned to the intervention group (61 subjects) or to the control group (62 subjects) depending on whether they had or had not carried out a home-based family-centred early developmental habilitation program focused on environmental enrichment, parent-guided environmental interaction, and infant development. Developmental outcome was assessed for both groups at 24 months’ corrected age using the Bayley Scales of Infant Development 2nd Edition. Intervention significantly improved both cognitive and behavioural outcomes. In addition, males had significantly lower scores than females either before or after treatment. However, the treatment was effective in both genders to the same extent. In conclusion, a timely updated environment suitable to the infant’s developmental needs could provide the best substrate where the parent-infant relationship can be practised with the ultimate goal of achieving further developmental steps.

scholarly journals Thromboembolic Rates Are Similar Between Intensive Care Unit and Nonintensive Care Unit Hospitalized Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Retrospective Cohort Study

2021 ◽  
Vol 27 ◽  
pp. 107602962110533
Author(s):  
Heidi Worth ◽  
Kasey Helmlinger ◽  
Renju Raj ◽  
Eric Heidel ◽  
Ronald Lands
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Thromboembolic Event ◽  
Hospitalized Patients ◽  
Thromboembolic Events ◽  
Icu Patients ◽  
Increased Risk

High rates of thromboembolic events have been described in intensive care unit (ICU) patients. Data regarding thromboembolic events in all hospitalized patients has been less frequently reported, raising concerns that thromboembolic events in non-ICU may be underrecognized. In addition, optimal anticoagulation type and dose is still unsettled at this time. This is a retrospective cohort study of 159 hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia during a 9-month period to determine an association between the frequency of thromboembolic rates and hospitalized patients with COVID-19. Secondary outcomes sought to investigate association of thromboembolic events with relation to place of admission, risk factors, anticoagulation, mortality, hospital length of stay, and discharge disposition. Among the cohort of 159 hospitalized patients who met criteria, 16 (10%) were diagnosed with a thromboembolic event. There were a total of 18 thromboembolic events with 12 venous and 6 arterial. Admission to the ICU was not associated with a higher frequency of thromboembolic events compared with non-ICU patients (37.5% vs 62.5%), p = .71. Patients with a thromboembolic event had a significantly higher mortality compared with those with no thromboembolic event (37.5% vs 13.3%), p = .012. Patients hospitalized with COVID-19 have increased rates of thromboembolic events, both venous and arterial, which contribute to a significant increase in mortality. However, the frequency of thromboembolism in patients admitted to the ICU was similar to events in non-ICU patients. We hope to increase awareness of the increased risk of hypercoagulability in all hospitalized patients with COVID-19 including non-ICU patients.

scholarly journals Prevalence, associated factors, and outcomes for labor induction at a tertiary hospital in Northern Tanzania: A retrospective cohort study 2000 - 2015

2020 ◽  
Author(s):  
Clifford Silver Tarimo ◽  
Jian Wu ◽  
Joseph Obure ◽  
Michael Johnson Mahande
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Neonatal Intensive Care ◽  
Variance Estimation ◽  
Tertiary Hospital ◽  
Labor Induction ◽  
Increased Risk

Abstract Background Labor induction (IOL) refers to an obstetric intervention which include artificial stimulation of uterine contraction aiming at vaginal delivery of a fetus before the onset of spontaneous labor. Despite undisputed importance of this intervention in improving pregnancy outcomes, data on its utilization and outcomes in Tanzania is limited. The aim of this study was to determine the prevalence, associated factors and outcomes for labor induction among women who were attended at a tertiary hospital in north-Tanzania. Methods We designed a retrospective cohort study and analyzed 53338 deliveries at the Kilimanjaro Christian Medical Centre (KCMC) between the year 2000 to 2015. We enrolled singleton deliveries with vertex presentation and excluded observations with missing information on induction status. Relative risk and 95% Confidence Interval for risk factors and outcomes of labor induction were estimated using log-binomial regression models. Robust variance estimation was used to account for repeated deliveries from the same subject. Results 53,338 deliveries were analyzed. Prevalence of labor induction was 21.63%. Independent risk factors for labor induction were; postdates (RR = 1.21; 95% CI: 1.15–1.28), fetal macrosomia (RR = 1.27; 95% CI: 1.18–1.36) and obesity (RR = 1.12; 95% CI: 1.06–1.18). Labor induction was associated with an increased risk of uterine rapture (RR = 1.84; 95% CI: 1.62–2.09) and low (< 7) Apgar score (RR = 1.27; 95% CI: 1.17–1.37). Labor induction offered protective effect against cesarean delivery (RR = 0.56; 95% CI: 0.53–0.58) and admission to neonatal intensive care unit (RR = 0.94; 95% CI: 0.89–0.99). Conclusion Efforts aimed at achieving the health-related sustainable development goals should focus on increasing access to effective interventions as well as improving quality of health care while being cautioned on likelihood of adverse maternal and fetal outcomes.

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