Diagnosis and cause of death in a neonatal intensive care unit – How important is autopsy?

Costa, Sandra; Rodrigues, Manuela; Centeno, Maria José; Martins, Angelina; Vilan, Ana; Brandão, Otília; Guimarães, Hercília

doi:10.3109/14767058.2010.520047

Cited by 20 publications

(32 citation statements)

References 9 publications

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“…Eight studies reported the mortality outcomes for all admissions to the NICU ( 20 , 22 , 25 , 33 – 37 ), five of which examined the age of infants at death ( 20 , 22 , 33 , 34 , 37 ). Musooko et al ( 37 ) noted that 45.9% (17/37) of infants with early neonatal deaths (death within 7 days of birth) and those with severe perinatal morbidity died on the first day of life in Uganda.…”

Section: Resultsmentioning

confidence: 99%

“…Musooko et al ( 37 ) noted that 45.9% (17/37) of infants with early neonatal deaths (death within 7 days of birth) and those with severe perinatal morbidity died on the first day of life in Uganda. The reported median age at death was 4 days in Australia ( 20 ), 4.4 days in Nigeria ( 33 ), and 10.5 days in Portugal ( 34 ). Sankaran et al ( 22 ) found that 75% (596/795) of deceased infants passed away 12 days since NICU admission in Canada (Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…The total mortality rates varied between countries. The overall in-hospital mortality rates were reported to be 3.1 and 3.8% in South Africa in 2007 and 2008, respectively ( 36 ), 4% in Canada from January 1996 to October 1997 ( 22 ), 5.7% in Portugal between 2004 and 2008 ( 34 ), 6.5% in Qatar from 2002 to 2006 ( 35 ), 8.1% in England between 2008 and 2010 ( 25 ), 9.2% in Australia across 1995–2006 ( 20 ), 14.2% in Nigeria between June 2012 and May 2013 ( 33 ), and 26–29% in Uganda in 2012 ( 37 ).…”

Section: Resultsmentioning

confidence: 99%

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A Selected Review of the Mortality Rates of Neonatal Intensive Care Units

Chow

Popovic

et al. 2015

Front. Public Health

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IntroductionNewborn babies in need of critical medical attention are normally admitted to the neonatal intensive care unit (NICU). These infants tend to be preterm, have low birth weight, and/or have serious medical conditions. Neonatal survival varies, but progress in perinatal and neonatal care has notably diminished mortality rates. In this selected review, we examine and compare the NICU mortality rates and etiologies of death in different countries.MethodsA literature search was conducted in Ovid MEDLINE, OLDMEDLINE, EMBASE Classic, and EMBASE. The primary endpoint was the mortality rates in NICUs. Secondary endpoints included the reasons for death and the correlation between infant age and mortality outcome. For the main analysis, we examined all infants admitted to NICUs. Subgroup analyses included extremely low birth weight infants (based on the authors’ own definition), very low birth weight infants, very preterm infants, preterm infants, preterm infants with a birth weight of ≤1,500 g, and by developed and developing countries.ResultsThe literature search yielded 1,865 articles, of which 20 were included. The total mortality rates greatly varied among countries. Infants in developed and developing countries had similar ages at death, ranging from 4 to 20 days and 1 to 28.9 days, respectively. The mortality rates ranged from 4 to 46% in developed countries and 0.2 to 64.4% in developing countries.ConclusionThe mortality rates of NICUs vary between nations but remain high in both developing and developed countries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A Selected Review of the Mortality Rates of Neonatal Intensive Care Units

Chow

Popovic

et al. 2015

Front. Public Health

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“…Costa et al. showed that in a cohort of 110 deceased infants, pathological and clinical diagnoses were in complete agreement in only 34% of cases and that PMs revised cause of death in 24.5% of cases. It is understandably difficult to approach grieving parents and relatives for permission to perform further examination on their deceased infants soon after death, especially when the clinician has little experience and training in this area.…”

Section: Discussionmentioning

confidence: 99%

Causes of death in infants admitted to Australian neonatal intensive care units between 1995 and 2006

et al. 2012

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“…Other studies, related to other pathologies, have shown that the necropsy �ndings and histological assessment of the lungs may change the diagnosis in a signi�cant number of cases [14,15].…”

Section: Discussionmentioning

confidence: 98%

Rescue High-Frequency Oscillatory Ventilation for Congenital Diaphragmatic Hernia: What about Lung Histopathology and Necropsy Findings?

2013

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Introduction. It is not yet a resolved issue whether HFOV (high-frequency oscillatory ventilation), used as primary mode or as rescue ventilation, has benefit over conventional mechanical ventilation for CDH (congenital diaphragmatic hernia) patients treatment. Purpose. To evaluate the success rate of rescue HFOV for CDH, and the histological characteristics of the lungs, at the autopsy of the deceased patients. Material and Methods. Out of 80 CDH patients, 10 were treated with rescue HFOV. The success of HFOV, histological exam of the lungs of deceased patients, and data on the followup of discharged patients were assessed. Results. Rescue HFOV was started between two hours and four days of life. The success rate of rescue HFOV was 20% (2/10). Autopsy findings along with pulmonary hypoplasia included coarctation of aorta (n=1), pneumonia (n=3), meconium aspiration (n=2), hyaline membranes (n=2), severe muscular hypertrophy of medium and small diameter lung arteries (n=1), severe lung hypoplasia (n=1), pleural effusions (n=2), haemorrhagic diatesis (n=2), and signs of overwhelming sepsis (n=1). The five-years follow up of the two survivors revealed normal growth and neurodevelopment. Conclusions. The results of this study support the idea that rescue HFOV may increase survival of CDH patients, when conventional mechanical ventilation fails.

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Diagnosis and cause of death in a neonatal intensive care unit – How important is autopsy?

Abstract: Despite the high agreement rate between clinical and pathological diagnoses, autopsy frequently added important data, including several cases in which it established the diagnosis or provided information relevant for parental counseling regarding future pregnancies.

Cited by 20 publications

References 9 publications

A Selected Review of the Mortality Rates of Neonatal Intensive Care Units

A Selected Review of the Mortality Rates of Neonatal Intensive Care Units

Causes of death in infants admitted to Australian neonatal intensive care units between 1995 and 2006

Rescue High-Frequency Oscillatory Ventilation for Congenital Diaphragmatic Hernia: What about Lung Histopathology and Necropsy Findings?

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