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09.07.2018 | Original Paper

Predictors of mortality for preterm infants with intraventricular hemorrhage: a population-based study

verfasst von: Rowland H. Han, Andrew McKinnon, Travis S. CreveCoeur, Brandon S. Baksh, Amit M. Mathur, Christopher D. Smyser, Jennifer M. Strahle, Margaret A. Olsen, David D. Limbrick Jr

Erschienen in: Child's Nervous System | Ausgabe 11/2018

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Abstract

Purpose

The goal of this longitudinal, population-level study was to examine factors affecting mortality in preterm infants with intraventricular hemorrhage (IVH).

Methods

The study examined patients who were born at 36 weeks estimated gestational age (EGA) or less with a diagnosis of IVH between the years 2005 and 2014 using data from the New York and Nebraska State Inpatient Databases. Potential predictors for mortality were investigated with multivariable survival analysis.

Results

The cohort included 7437 preterm infants with IVH. All-cause inpatient mortality occurred in 746 (10.0%). The majority of deaths were in infants born at less than 25 weeks EGA (378 or 50.7%) and with birthweight less than 750 g (459 or 61.5%). Mortality was highest for children with grade IV IVH (306/848 or 36.1%), followed by grades III (203/955 or 21.3%), II (103/1328 or 7.8%), and I (134/4306 or 3.1%). Hydrocephalus was diagnosed within 6 months in 627 (8.4%) patients, with cerebrospinal fluid shunts required in 237 (3.2%). Shunts were eventually revised in 122 (51.5% of shunts), and 43 (18.1%) had infections. Multivariable Cox survival analyses found male sex (HR 1.3 [95% CI 1.1–1.5]), Asian race (HR 1.5 [1.1–2.2]), lower EGA (HR 9.9 [6.3–15.5] for < 25 weeks), higher IVH grade (HR 6.1 [4.9–7.6] for grade IV), gastrostomy (HR 4.0 [2.0–7.7]), tracheostomy (HR 3.5 [1.7–7.1]), and shunt infection (HR 3.2 [1.0–9.9]) to be independently associated with increased mortality risk.

Conclusions

This database is the first of its kind assembled for population-based investigations of long-term neurosurgical outcomes in preterm infants with IVH.

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Titel: Predictors of mortality for preterm infants with intraventricular hemorrhage: a population-based study
verfasst von: Rowland H. Han
Andrew McKinnon
Travis S. CreveCoeur
Brandon S. Baksh
Amit M. Mathur
Christopher D. Smyser
Jennifer M. Strahle
Margaret A. Olsen
David D. Limbrick Jr
Publikationsdatum: 09.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Child's Nervous System / Ausgabe 11/2018
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-018-3897-4

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