婴儿期喉气管支气管异常以及与住院期间死亡的相关危险因素
2016/06/20
摘要
背景：喉气管支气管异常（LTBAs）可能引起婴儿早期的呼吸系统问题，并增加生病儿童住院或死亡的风险。本研究将考察被诊断为喉气管支气管异常的婴儿5岁内首次住院的年龄和住院死亡的危险因素。
方法：从台湾全民健康保险研究资料库调取从2003年到2005年确诊为LTBAs的住院婴儿。他们的医疗数据随访到59月龄。对所有LTBA病例的年龄分布进行分析，然后将婴儿分成两个年龄组。同时分析了住院并发症与住院死亡危险因素。
结果：总共检索了1272个LTBA案例。他们中的大多数（976，76.7%）最初是在0-3个月时住院，47例（3.7%）死亡。这些患者被分为早发和晚发LTBA组，年龄分别为0~3月龄和4-11月龄。晚发LTBA组的患者有更明显的急性呼吸道感染或哮喘和神经系统疾病，住院更频繁，住院时间更长，而且比早期LTBA组住院病死率更高（P＜0.001＝。住院死亡率校正后的比值比（aORs）在4-11月龄[ aOR = 2.50，95%可信区间（CI）：1.36-4.60 ] 儿童中显著增高，或有围产期疾病（aOR = 2.00，95%可信区间：1.07-3.73），心血管疾病（aOR = 2.45，95%可信区间：1.30-4.60）、其它先天性异常（aOR = 2.42，95%可信区间：1.28-4.60），和神经系统疾病（aOR = 2.32，95%可信区间：1.18-4.53）。
结论：大多数患LTBAs的婴儿初诊和住院时的为3月龄或者更小。患LTBAs儿童的住院死亡率的危险因素包括：在4月龄或者更大时诊断和治疗LTBA，围产期疾病、心血管异常，其它先天性异常，神经系统疾病，以及4月龄或者更大的年龄。
（杨冬 审校）
JChinMedAssoc. 2016 Apr;79(4):221-7.doi:10.1016/j.jcma.2015.12.001.Epub 2016 Jan 19.
Laryngotracheobronchial anomalies in infants and the related risk factors of in-hospital mortality.
Lee KL1, Chen TJ2, Jeng MJ3, Lee YS4, Tsao PC4, Soong WJ4.
Author information
Abstract
BACKGROUND:Laryngotracheobronchial anomalies (LTBAs) may cause respiratory problems during early childhood, and increase the risk of hospitalization or mortality in diseased children. This study investigated the initial hospitalization age and risk factors for in-hospital mortality in infants diagnosed with LTBAs during their first 5 years of life.
METHODS:Hospitalized infants diagnosed with LTBAs were retrieved from Taiwan's National Health Insurance Research Database from 2003 to 2005. Their medical claim data were traced up to 59 months of age. The age distribution of all LTBA cases was analyzed, and then the enrolled infants were grouped into two age groups. Hospitalization-related comorbidities and risk factors for in-hospital mortality were also analyzed.
RESULTS:A total of 1272 LTBA cases were retrieved. Most of them (976, 76.7%) were initially hospitalized at an age of 0-3 months, and 47 infants (3.7%) died. These enrolled cases were grouped into early and late LTBA groups, with ages of 0-3 months and 4-11 months, respectively. Patients in the late LTBA group had significantly more acute airway infections/asthma and neurological diseases, more frequent hospitalizations, longer hospitalization stay, and higher in-hospital mortality than did the early LTBA group (p < 0.001). The adjusted odds ratios (aORs) for in-hospital mortality were significantly higher in the children aged 4-11 months [aOR = 2.50, 95% confidence intervals (CI): 1.36-4.60], or having perinatal disease (aOR = 2.00, 95% CI: 1.07-3.73), cardiovascular disease (aOR = 2.45, 95% CI: 1.30-4.60), other congenital anomalies (aOR = 2.42, 95% CI: 1.28-4.60), and neurological diseases (aOR = 2.32, 95% CI: 1.18-4.53).
CONCLUSION:Most infants with LTBAs were initially diagnosed and hospitalized when they were aged 3 months or younger. The risk factors for in-hospital mortality of the children with LTBAs included being diagnosed and treated at an age of 4 months and older, and the presence of perinatal disease, cardiovascular anomalies, other congenital anomalies, neurological diseases, and an age of 4 months and older.
Copyright © 2016. Published by Elsevier Taiwan LLC.
KEYWORDS:airway anomaly; airway malacia; hospitalization; in-hospital mortality; infant
JChinMedAssoc. 2016 Apr;79(4):221-7.doi:10.1016/j.jcma.2015.12.001.Epub 2016 Jan 19.
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