medigraphic.com
ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2019, Number 2

<< Back Next >>

An Med Asoc Med Hosp ABC 2019; 64 (2)

Characteristics and risk factors for hospitalization in preterm infants at their first emergency visit

Martínez PSL, Martina LM, Iglesias LJ, Bernárdez ZI, Treviño BX

Language: Spanish
References: 15
Page: 81-86
PDF size: 188.68 Kb.


ABSTRACT

Background: Complications related to the prematurity are the main cause of death in children under five years, causing one million deaths in 2015. Readmission rates of late preterm infants are 1.5-3 higher than term infants. Objective: To describe the characteristics and risk factors for the hospitalization in preterm infants who visit the Emergency room for the first time in their first year of life. Material and methods: Retrospective, descriptive and analytical study carried out in the pediatric emergency department of the Hospital Español de México between January 2014 and December 2015. The files were reviewed to record the maternal, perinatal and the diagnostic data that were recorded upon admission to emergency room and hospitalization areas. Results: 1,533 children under one year of age visited the emergency department, n = 202 being premature, 78.2% were late preterm, 64.4% had a low birth weight. The main risk factors for hospitalization were respiratory distress [RR = 77.36 (CI95% 10.1-591.5), p ‹ 0.001], potentially lethal event [RR = 27.71 (CI95% 3.36-228.25), p = 0.002] and gastroenteritis [RR = 7.68 (CI95% 2.23-26.46), p = 0.001]. Conclusions: There was a predominance of male sex, firstborn, late preterms and low birth weight in patients who visit the emergency department for the first time. The main risk factors for hospitalization were younger age on arrival at the emergency room, lower gestational age and low birth weight, diagnosis of respiratory distress, acute gastroenteritis and oral intolerance.


REFERENCES

  1. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2016; 388 (10063): 3027-3035.

  2. Nota descriptiva Nº 363, noviembre 2017, OMS. Disponible en: http://www.who.int/mediacentre/factsheets/fs363/es/.

  3. Lacobelli S, Combier E, Roussot A, Cottenet J, Gouyon JB, Quantin C. Gestational age and 1-year hospital admission or mortality: a nation-wide population-based study. BMC Pediatr. 2017; 17 (28): 1-9.

  4. Kuzniewicz MW, Parker SJ, Schnake-Mahl A, Escobar GJ. Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants. Clin Perinatol. 2013; 40 (4): 753-775.

  5. Ray KN, Lorch SA. Hospitalization of early preterm, late preterm, and term infants during the first year of life by gestational age. Hosp Pediatr. 2013; 3 (3): 194-203.

  6. Moyer LB, Goyal NK, Meinzen-Derr J, Ward LP, Rust CL, Wexelblatt SL et al. Factors associated with readmission in late-preterm infants: a matched case-control study. Hosp Pediatr. 2014; 4 (5): 298-304.

  7. Lee HC, Bardach NS, Maselli JH, Gonzales R. Emergency department visits in the neonatal period in the United States. Pediatr Emerg Care. 2014; 30 (5): 315-318.

  8. Batu ED, Yeni S, Teksam O. The factors affecting neonatal presentations to the pediatric emergency department. J Emerg Med. 2015; 48 (5): 542-547.

  9. Raju TN, Higgins Rd, Stark AR, Leveno KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the national institute of child health and human development. Pediatrics. 2006; 118 (3): 1207-1214.

  10. Perry AM, Caviness AC, Allen JY. Characteristics and diagnoses of neonates who revisit a pediatric emergency center. Pediatr Emerg Care. 2013; 29 (1): 58-62.

  11. Ramachandrappa A, Jain L. Health issues of the late preterm infant. Pediatr Clin North Am. 2009; 56 (3): 565-577.

  12. Pomerantz WJ, Schubert CJ, Atherton HD, Kotagal UR. Characteristics of nonurgent emergency department use in the first 3 months of life. Pediatr Emerg Care. 2002; 18 (6): 403-408.

  13. Picone S, Paolillo P. Neonatal outcomes in a population of late –preterm infants. J Matern Fetal Neonatal Med. 2010; 23 (Suppl 3): 116-120.

  14. Escobar GJ, Joffe S, Gardner MN, Armstrong MA, Folck BF, Carpenter DM. Rehospitalization in the first two weeks after discharge from the neonatal intensive care unit. Pediatrics. 1999; 104 (1): e2.

  15. Ambalavanan N, Carlo WA, McDonald SA, Yao Q, Das A, Higgins RD. Identification of extremely premature infants at high risk of rehospitalization. Pediatrics. 2011; 128 (5): e1216-e225.




2020     |     www.medigraphic.com