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Predicting Risk of Infection in Infants with Congenital Diaphragmatic Hernia.
Murthy, Karna; Porta, Nicolas F M; Pallotto, Eugenia K; Rintoul, Natalie; Keene, Sarah; Chicoine, Louis; Gien, Jason; Brozanski, Beverly S; Johnson, Yvette R; Haberman, Beth; DiGeronimo, Robert; Zaniletti, Isabella; Grover, Theresa R.
Afiliação
  • Murthy K; Ann and Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL; The Children's Hospitals Neonatal Consortium, Kansas City, MO. Electronic address: kmurthy@luriechildrens.org.
  • Porta NFM; Ann and Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL.
  • Pallotto EK; The Children's Hospitals Neonatal Consortium, Kansas City, MO; Children's Mercy Hospitals and Clinics, Department of Pediatrics, University of Missouri Kansas City School of Medicine, Kansas City, MO.
  • Rintoul N; Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Keene S; Children's Healthcare of Atlanta at Egleston, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
  • Chicoine L; Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH.
  • Gien J; Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.
  • Brozanski BS; The Children's Hospitals Neonatal Consortium, Kansas City, MO; Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Johnson YR; Cook Children's Hospital, Fort Worth, TX.
  • Haberman B; Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH.
  • DiGeronimo R; Seattle Children's Hospital, University of Washington, Seattle, WA.
  • Zaniletti I; Children's Hospital Association, Inc, Overland Park, KS.
  • Grover TR; The Children's Hospitals Neonatal Consortium, Kansas City, MO; Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.
J Pediatr ; 203: 101-107.e2, 2018 12.
Article em En | MEDLINE | ID: mdl-30217691
OBJECTIVE: To predict incident bloodstream infection and urinary tract infection (UTI) in infants with congenital diaphragmatic hernia (CDH). STUDY DESIGN: We conducted a retrospective analysis using the Children's Hospital Neonatal Database during 2010-2016. Infants with CDH admitted at 22 participating regional neonatal intensive care units were included; patients repaired or discharged to home prior to admission/referral were excluded. The primary outcome was death or the occurrence of bloodstream infection or UTI prior to discharge. Factors associated with this outcome were used to develop a multivariable equation using 80% of the cohort. Validation was performed in the remaining 20% of infants. RESULTS: Median gestation and postnatal age at referral in this cohort (n = 1085) were 38 weeks and 3.1 hours, respectively. The primary outcome occurred in 395 patients (36%); and was associated with low birth weight, low Apgar, low admission pH, renal and associated anomalies, patch repair, and extracorporeal membrane oxygenation (P < .001 for all; area under receiver operating curve = 0.824; goodness of fit χ2 = 0.52). After omitting death from the outcome measure, admission pH, patch repair of CDH, and duration of central line placement were significantly associated with incident bloodstream infection or UTI. CONCLUSIONS: Infants with CDH are at high risk of infection which was predicted by clinical factors. Early identification and low threshold for sepsis evaluations in high-risk infants may attenuate acquisition and the consequences of these infections.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Urinárias / Bacteriemia / Hérnias Diafragmáticas Congênitas Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Urinárias / Bacteriemia / Hérnias Diafragmáticas Congênitas Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2018 Tipo de documento: Article País de publicação: Estados Unidos