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Factores pronóstico para mortalidad en recién nacidos con hernia de Bochdalek. Estudio de casos y controles. (Spanish)
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- Author(s): Reed-López Güereña, Francisco; Bracho-Blanchet, Eduardo; Dávila-Pérez, Roberto; Zalles-Vidal, Cristian; Esperante-Lozano, Sandro; Nieto-Zermeño, Jaime
- Source:
Cirugía y Cirujanos; jul/ago2011, Vol. 79 Issue 4, p305-311, 7p- Subject Terms:
- Source:
- Additional Information
- Alternate Title: Prognostic Factors Related to Mortality in Newborns With Bochdalek Hernia. A Case-control Study. (English)
- Subject Terms:
- Abstract: Background: Bochdalek hernia remains an entity carrying a high mortality. Because there are no published studies about prognostic factors for mortality in Bochdalek hernia in underdeveloped countries, we designed the present study. Our objective was to determine the prognostic factors related to mortality in Bochdalek hernia in countries such as Mexico. Methods: We designed a case (deceased)-control (alive) study during a 10-year period analyzing epidemiological and pre-, intra- and postoperative factors related to mortality. Our protocol is to operate when the patient is hemodynamically stable. Results: We analyzed 11 cases and 38 controls. There was pulmonary hypertension in 65% of the patients. Associated anomalies were not related to mortality. Low Apgar score (p = 0.016), the need for high frequency ventilation (p = 0.003) or having postoperative complications (p = 0.025) were related to mortality with pulmonary hypertension being the main cause. Odds ratios showed that immediate intubation, preoperative pulmonary hypertension (p = 0.05) and the necessity for preoperative stabilization (p = 0.043) increased mortality risk by 1.5 times. Using preoperative high-frequency ventilation increased the risk nine times and, when needed postoperatively, increases the risk 11 times. Conclusions: Factors related to mortality were low Apgar score, immediate intubation, need for stabilization, postoperative complications and need for high-frequency ventilation. [ABSTRACT FROM AUTHOR]
- Abstract: Introducción: La hernia de Bochdalek sigue teniendo alta mortalidad. Diseñamos la presente investigación al no existir en nuestro medio estudios de factores pronóstico de mortalidad. Objetivo: conocer los factores que en países en desarrollo influyen en la mortalidad en pacientes con hernia de Bochdalek. Material y métodos: Estudio retrospectivo de un periodo de 10 años, tipo casos (fallecidos) y controles (sobrevivientes) en el que se analizaron factores epidemiológicos, pre, trans y posoperatorios asociados con la mortalidad. Nuestro protocolo es realizar intervención quirúrgica ante estabilidad hemodinámica. Resultados: Se analizaron 11 casos y 38 controles. Existió hipertensión pulmonar en 65% y las malformaciones asociadas no se relacionaron con la mortalidad. El Apgar bajo (p = 0.016), requerir ventilación de alta frecuencia (p = 0.003) o la presencia de complicación posquirúrgica (p = 0.025) (principalmente por hipertensión pulmonar) se asociaron con mayor mortalidad. En razones de momios, la intubación neonatal inmediata, la hipertensión pulmonar preoperatoria (p = 0.05) y la necesidad de estabilización (p = 0.043) aumentaron el riesgo de muerte aproximadamente 1.5 veces. La utilización de alta frecuencia preoperatoria incrementó el riesgo nueve veces y en el posoperatorio 11 veces. Conclusiones: Los factores asociados con mortalidad fueron Apgar bajo, intubación al nacer, necesidad de estabilización, hipertensión pulmonar, complicación quirúrgica y requerir ventilación de alta frecuencia. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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