Document Detail


Risk factors for adverse outcome of newborns with gastroschisis in a Brazilian hospital.
MedLine Citation:
PMID:  11283877     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: The aim of this study was to determine the frequency of postoperative death and to identify factors associated with adverse prognosis in cases of gastroschisis managed in a tertiary hospital of Brazil. METHODS: A retrospective transverse study was conducted including all cases of gastroschisis managed at Instituto Materno-Infantil De Pernambuco (IMIP), Recife, Brazil, between January 1995 and December 1999 (n = 31). Prevalence risk (PR) was determined for several prenatal, intraoperative, and postoperative factors. RESULTS: Overall mortality rate was 52% (16 cases), and sepsis was the main cause of death (93.8%). Prenatal diagnosis reduced about 70% the risk of death. Preterm and low birth weight babies had about 3 times increase in the risk of death. Risk of death was increased twice among outborn babies, but there was no association with delivery route. Increase in risk of neonatal death was related to these other factors: birth-to-admission interval longer than 2 hours and birth-to-surgery interval longer than 4 hours. Prevalence risk also was greater with staged silo repair, poor clinical conditions before surgery, and when mechanical ventilation was needed. CONCLUSIONS: A high mortality rate was associated with absence of prenatal diagnosis, prematurity, low birth weight, delivery outside the tertiary center, and delayed surgery, worsening clinical conditions that preclude primary closure and increases need of mechanical ventilation. J Pediatr Surg 36:559-564.
Authors:
P C Vilela; M M Ramos De Amorim; G H Falbo; L C Santos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  36     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-03     Completed Date:  2001-09-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  559-64     Citation Subset:  IM    
Copyright Information:
Copyright 2001 by W.B. Saunders Company.
Affiliation:
Departments of Pediatric Surgery and Gynecology, Instituto Materno-Infantil de Pernambuco, Rua dos Coelhos 300, Ilha do Leite, Recife, Pernambuco, Brazil, CEP:50070-550.
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MeSH Terms
Descriptor/Qualifier:
Brazil / epidemiology
Digestive System Surgical Procedures*
Female
Gastroschisis / diagnosis,  mortality*,  surgery*
Hospitals, Pediatric
Humans
Incidence
Infant, Newborn
Logistic Models
Male
Multivariate Analysis
Postoperative Complications / mortality*
Probability
Regression Analysis
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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