Cristina Nogueroles Blanco, Ana Herranz-Barbero, Mar Velilla-Aparicio, Carla Balcells-Esponera, Marta Teresa-Palacio, Miguel Alsina Casanova, Cristina Carrasco Carrasco, Cristina Borràs-Novell, José Manuel Rodríguez-Miguélez, Ma Dolors Salvia-Roigés, Victoria Aldecoa-Bilbao
{"title":"早产儿气胸的相关风险因素和结果","authors":"Cristina Nogueroles Blanco, Ana Herranz-Barbero, Mar Velilla-Aparicio, Carla Balcells-Esponera, Marta Teresa-Palacio, Miguel Alsina Casanova, Cristina Carrasco Carrasco, Cristina Borràs-Novell, José Manuel Rodríguez-Miguélez, Ma Dolors Salvia-Roigés, Victoria Aldecoa-Bilbao","doi":"10.3390/children11101179","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/objectives: </strong>Pneumothorax can be a major complication of neonatal lung diseases. We aim to delineate trends and describe the main outcomes related to pneumothorax in very preterm infants (VPI).</p><p><strong>Methods: </strong>Preterm infants < 32 weeks of gestation admitted in two-level III neonatal intensive care units (1995-2019) were included. Risk factors and outcomes were assessed by logistic regression and adjusted for gestational age (GA).</p><p><strong>Results: </strong>In total, 4271 VPI with a mean GA of 28.7 ± 2.3 weeks were evaluated. Pneumothorax was diagnosed in 174 patients (4.1%, 95% Confidence Interval (CI) 3.5-4.7) with its incidence inversely proportional to GA: 9.9% in 23-25 w and 2.1% in 30-31 w (<i>p</i> < 0.001), but stable over the years 1995-1999 (5.2%) and 2015-2019 (4.2%) (<i>p</i> = 0.309). Patients with pneumothorax exhibited higher rates of severe intraventricular hemorrhage (IVH) (Odds Ratio (OR) = 2.0 (95%CI 1.3-3.1), <i>p</i> = 0.003), bronchopulmonary dysplasia (OR = 2.7 (95%CI 1.7-4.4), <i>p</i> < 0.001), and death (OR = 8.5 (95%CI 6.2-11.6), <i>p</i> < 0.001). Independent risk factors for pneumothorax were GA, prolonged premature rupture of membranes, and intubation in the delivery room. The composite outcome of death or severe IVH was higher in patients with pneumothorax with an adjusted OR = 6.7 (95%CI 4.7-9.6), <i>p</i> < 0.001. Although VPI mortality has significantly decreased over the years (20.3% 1995-1999 and 11.7% 2015-2019, <i>p</i> < 0.001), we found no significant difference in pneumothorax-related deaths.</p><p><strong>Conclusion: </strong>Pneumothorax remains a serious threat to VPI, leading to a higher incidence of morbidity, and mortality attributable to this complication has not decreased. Preventive strategies and early recognition are essential for improving disability-free survival in VPI.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506549/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk Factors and Outcomes Associated with Pneumothorax in Very Preterm Infants.\",\"authors\":\"Cristina Nogueroles Blanco, Ana Herranz-Barbero, Mar Velilla-Aparicio, Carla Balcells-Esponera, Marta Teresa-Palacio, Miguel Alsina Casanova, Cristina Carrasco Carrasco, Cristina Borràs-Novell, José Manuel Rodríguez-Miguélez, Ma Dolors Salvia-Roigés, Victoria Aldecoa-Bilbao\",\"doi\":\"10.3390/children11101179\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/objectives: </strong>Pneumothorax can be a major complication of neonatal lung diseases. We aim to delineate trends and describe the main outcomes related to pneumothorax in very preterm infants (VPI).</p><p><strong>Methods: </strong>Preterm infants < 32 weeks of gestation admitted in two-level III neonatal intensive care units (1995-2019) were included. Risk factors and outcomes were assessed by logistic regression and adjusted for gestational age (GA).</p><p><strong>Results: </strong>In total, 4271 VPI with a mean GA of 28.7 ± 2.3 weeks were evaluated. Pneumothorax was diagnosed in 174 patients (4.1%, 95% Confidence Interval (CI) 3.5-4.7) with its incidence inversely proportional to GA: 9.9% in 23-25 w and 2.1% in 30-31 w (<i>p</i> < 0.001), but stable over the years 1995-1999 (5.2%) and 2015-2019 (4.2%) (<i>p</i> = 0.309). Patients with pneumothorax exhibited higher rates of severe intraventricular hemorrhage (IVH) (Odds Ratio (OR) = 2.0 (95%CI 1.3-3.1), <i>p</i> = 0.003), bronchopulmonary dysplasia (OR = 2.7 (95%CI 1.7-4.4), <i>p</i> < 0.001), and death (OR = 8.5 (95%CI 6.2-11.6), <i>p</i> < 0.001). Independent risk factors for pneumothorax were GA, prolonged premature rupture of membranes, and intubation in the delivery room. The composite outcome of death or severe IVH was higher in patients with pneumothorax with an adjusted OR = 6.7 (95%CI 4.7-9.6), <i>p</i> < 0.001. Although VPI mortality has significantly decreased over the years (20.3% 1995-1999 and 11.7% 2015-2019, <i>p</i> < 0.001), we found no significant difference in pneumothorax-related deaths.</p><p><strong>Conclusion: </strong>Pneumothorax remains a serious threat to VPI, leading to a higher incidence of morbidity, and mortality attributable to this complication has not decreased. Preventive strategies and early recognition are essential for improving disability-free survival in VPI.</p>\",\"PeriodicalId\":48588,\"journal\":{\"name\":\"Children-Basel\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11506549/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Children-Basel\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/children11101179\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Children-Basel","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/children11101179","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Risk Factors and Outcomes Associated with Pneumothorax in Very Preterm Infants.
Background/objectives: Pneumothorax can be a major complication of neonatal lung diseases. We aim to delineate trends and describe the main outcomes related to pneumothorax in very preterm infants (VPI).
Methods: Preterm infants < 32 weeks of gestation admitted in two-level III neonatal intensive care units (1995-2019) were included. Risk factors and outcomes were assessed by logistic regression and adjusted for gestational age (GA).
Results: In total, 4271 VPI with a mean GA of 28.7 ± 2.3 weeks were evaluated. Pneumothorax was diagnosed in 174 patients (4.1%, 95% Confidence Interval (CI) 3.5-4.7) with its incidence inversely proportional to GA: 9.9% in 23-25 w and 2.1% in 30-31 w (p < 0.001), but stable over the years 1995-1999 (5.2%) and 2015-2019 (4.2%) (p = 0.309). Patients with pneumothorax exhibited higher rates of severe intraventricular hemorrhage (IVH) (Odds Ratio (OR) = 2.0 (95%CI 1.3-3.1), p = 0.003), bronchopulmonary dysplasia (OR = 2.7 (95%CI 1.7-4.4), p < 0.001), and death (OR = 8.5 (95%CI 6.2-11.6), p < 0.001). Independent risk factors for pneumothorax were GA, prolonged premature rupture of membranes, and intubation in the delivery room. The composite outcome of death or severe IVH was higher in patients with pneumothorax with an adjusted OR = 6.7 (95%CI 4.7-9.6), p < 0.001. Although VPI mortality has significantly decreased over the years (20.3% 1995-1999 and 11.7% 2015-2019, p < 0.001), we found no significant difference in pneumothorax-related deaths.
Conclusion: Pneumothorax remains a serious threat to VPI, leading to a higher incidence of morbidity, and mortality attributable to this complication has not decreased. Preventive strategies and early recognition are essential for improving disability-free survival in VPI.
期刊介绍:
Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries.
The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.