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A Study on the Case Fatality Rate and Determinants of Respiratory Failure in Neonates at a Gestational Age of 34 Weeks or More

Author: MouJinSong
Tutor: LuoJiaYou
School: Central South University
Course: Child and adolescent health and maternal and child health
Keywords: Newborn Respiratory failure Mortality Influencing factors
CLC: R722.1
Type: Master's thesis
Year: 2010
Downloads: 50
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Abstract


Objective: To investigate the 34 weeks and neonatal respiratory failure mortality and its influencing factors based on research to reduce neonatal deaths. Methods: A case analysis method, were investigated retrospectively from January 2008 to August 2009, 782 cases admitted to a top three Children's Hospital of Hunan Province, 34 weeks or more respiratory failure in children. Using EpiData3.02 data entry applications descriptive statistical methods to analyze the basic characteristics and mortality of children, χ2 test to analyze differences in mortality rate; Multivariate Logistic regression model screening respiratory failure in children died influencing factors. Results: 782 cases of respiratory failure in children, the male to female ratio of 3.27:1, the average gestational age (38.45 ± 2.13) weeks, mean birth weight (2908.28 ± 607.14) g, the average hospital cost (13858.06 ± 9797.61) yuan . Disease primary respiratory failure, respiratory distress syndrome, a lung infection / sepsis, wet lung, meconium aspiration syndrome and hypoxic-ischemic encephalopathy as a primary disease of respiratory failure in children with the proportion of 22.2% , 21.4%, 21.0%, 13.8% and 11.6%, respectively. Respiratory failure in children with normal frequency mechanical ventilation treatment ratio of 50.6%. Respiratory failure in children with a mortality rate of 22.8%, no statistically significant differences between different gender mortality (χ 2 = 2.826, P = 0.093); 37-38 weeks respiratory failure in children and 39-41 weeks of respiratory failure in children died rate (24.9% and 26.7%, respectively) were higher than 34-36 weeks of respiratory failure in children mortality (12.4%), the difference was statistically significant (χ 2 = 10.089, P = 0.001; χ2 = 14.715, P = 0.000); lung infection / sepsis, hypoxic-ischemic encephalopathy and meconium aspiration syndrome primary disease of respiratory failure in children with higher mortality, respectively, 32.5%, 31.3% and 29.2%, respiratory distress syndrome and The wet lung lower mortality, 15.5% and 9.6%, respectively. Multivariate logistic regression analysis showed that: congenital malformations (OR = 2.456), into the NICU older (OR = 2.423) higher SNAPPE-II score (OR = 5.518) and mechanical ventilation (OR = 3.806) higher risk of children died of respiratory failure; mechanical ventilation time was 3.1-7.0 days (OR = 0.066), respiratory failure in children died less dangerous. Conclusion: 34 weeks and above neonatal respiratory failure mortality, should be concerned about its impact factors, and take the necessary measures to carry out the intervention, in order to raise children with respiratory failure survival.

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CLC: > Medicine, health > Pediatrics > Newborns, premature children disease > Neonatal disease
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