Predicting mortality in neonates with gastroschisis in a Southeastern state of Brazil.

Autor:	Muniz VM; Universidade Federal do Espírito Santo, Postgraduate Program in Collective Health - Vitória (ES), Brazil.; Hospital Estadual Infantil Nossa Senhora da Glória - Vitória (ES), Brazil., Lima Netto A; Hospital Estadual Infantil Nossa Senhora da Glória - Vitória (ES), Brazil., Carvalho KS; Hospital Estadual Infantil e Maternidade Alzir Bernardino Alves - Vila Velha (ES), Brazil., Valle CSD; Hospital Estadual Dr. Jayme Santos Neves - Serra (ES), Brazil., Martins CA; Universidade Federal do Espírito Santo, Postgraduate Program in Nutrition and Health - Vitória (ES), Brazil., Salaroli LB; Universidade Federal do Espírito Santo, Postgraduate Program in Collective Health - Vitória (ES), Brazil.; Universidade Federal do Espírito Santo, Postgraduate Program in Nutrition and Health - Vitória (ES), Brazil., Zandonade E; Universidade Federal do Espírito Santo, Postgraduate Program in Collective Health - Vitória (ES), Brazil.
Jazyk:	angličtina
Zdroj:	Revista da Associacao Medica Brasileira (1992) [Rev Assoc Med Bras (1992)] 2023 Feb 10; Vol. 69 (2), pp. 314-319. Date of Electronic Publication: 2023 Feb 10 (Print Publication: 2023).
DOI:	10.1590/1806-9282.20221116
Abstrakt:	Objective: This study aimed to verify risk factors associated with gastroschisis mortality in three neonatal intensive care units located in the state of Espírito Santo, Brazil. Methods: A retrospective cohort study of neonates with gastroschisis was performed between 2000 and 2018. Prenatal, perinatal, and postsurgical variables of survival or nonsurvival groups were compared using chi-square statistical test, t-test, Mann-Whitney U test, and logistic regression. Tests with p<0.05 were considered statistically determined. Results: A total of 142 newborns were investigated. Mean maternal age, gestational age, and birth weight were lower in the group of nonsurvival (p<0.05). Poor clinical conditions during admission, complex gastroschisis, closure with silo placement, the use of blood products, surgical complications, and short bowel syndrome were more frequent in the nonsurvival group (p<0.05). Complex gastroschisis [adjusted odds ratio (OR) 3.74, 95% confidence interval (95%CI) 1.274-11.019] and short bowel syndrome (adjusted OR 7.55, 95%CI 2.177-26.225) increased the risk of death. Higher birth weight inversely reduced the risk for mortality (adjusted OR 0.99, 95%CI 0.997-1.000). Conclusion: Complex gastroschisis and short bowel syndrome increased the risk of death, with greater birth weight being inversely correlated with the risk of mortality. The findings of this research can contribute to the formulation of protocols to improve the quality and safety of care in order to reduce neonatal mortality associated with gastroschisis.
Databáze:	MEDLINE
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