Factors related to survival discharge in trisomy 18: A retrospective multicenter study
| Autor: | Seiji Hayashi, Ayako Yasuda, Yuma Kitase, Tetsuo Hattori, Yuichi Kato, Koji Takemoto, Takashi Tachibana, Kuniko Ieda, Eiko Kato, Yukako Muramatsu, Yoshiaki Sato, Hikaru Yamamoto, Makoto Oshiro, Akiko Saito, Masahiro Hayakawa |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Home Nursing Gestational Age Disease Gestation period Pregnancy Ductus arteriosus Intensive care noninvasive Infant Mortality Genetics medicine Birth Weight Humans trisomy 18 Survival rate Genetics (clinical) Retrospective Studies Cause of death cardiovascular surgery business.industry Infant Newborn Infant extremely low birthweight infant Prognosis medicine.disease Home Care Services Survival Analysis Patient Discharge prenatal genetic test medicine.anatomical_structure home healthcare Cardiovascular Diseases Atresia Female business Trisomy Trisomy 18 Syndrome |
| Zdroj: | American Journal of Medical Genetics Part A. 179(7):1253-1259 |
| ISSN: | 1552-4825 |
| Popis: | Infants with trisomy 18 (T18) previously had a poor prognosis; however, the intensive care of these patients has markedly diversified the prognosis. We investigated the current situation of patients with T18, clarified factors for survival discharge, and surveyed actual home healthcare. A total of 117 patients with T18 admitted to nine institutions between 2000 and 2015 were retrospectively investigated. After excluding four patients whose outcomes were unclear, we divided 113 patients into two groups—the survival discharge group (n = 52) and the death discharge group (n = 61)—and compared maternal factors, perinatal factors, neonatal factors, and therapeutic factors between the groups. In addition, home healthcare, readmission, utilization of respite care and home nursing, and cause of death among the survival group were surveyed. Fifty‐two (44%) patients with T18 survived at discharge and their 1‐year survival rate was 29%. The survival group had a longer gestation period, larger physique, and longer survival time, compared to the death group. Independent factors associated with survival discharge were the absence of an extremely low birthweight infant (ELBWI), the absence of esophageal atresia and patent ductus arteriosus, and cardiovascular surgery. All surviving patients required some home healthcare. The most frequent cause of death was a respiratory disorder. We recommend discussing the treatment strategy with families in the presence of neonatologists or pediatric surgeons, who can explain differences in prognosis, based on the gestation period, birthweight, severity of cardiovascular disease, and cardiovascular surgery. ファイル公開：2019-07-01 |
| Databáze: | OpenAIRE |
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