Çocuk Sağlığı ve Hastalıkları Dergisi 2008 , Vol 51 , Num 3
Hypoxic ischemic encephalopathy in neonatal intensive care units of Turkey: risk factors, incidence and short-term prognosis
Türk Neonatoloji Derneği Hipoksik İskemik Ensefalopati Çalışma Grubu
Türk Neonatoloji Derneği Hipoksik İskemik Ensefalopati Çalışma Grubu* Adnan Menderes Üniversitesi, Akdeniz Üniversitesi, Ankara Üniversitesi, Atatürk Üniversitesi, Çukurova Üniversitesi, Dokuz Eylül Üniversitesi, Ege Üniversitesi, Gazi Üniversitesi, Hacettepe Üniversitesi, İstanbul Üniversitesi (İstanbul Tıp Fakültesi), Kocaeli Üniversitesi, Marmara Üniversitesi, Mersin Üniversitesi, Pamukkale Üniversitesi, Trakya Üniversitesi, Uludağ Üniversitesi Tıp Fakülteleri Yenidoğan Yoğun Bakım Üniteleri** Despite advances in diagnosis and treatment of hypoxic ischemic encephalopathy (HIE), it is still an important problem in Neonatal Intensive Care Units (NICUs). Sixteen university hospitals from different regions of Turkey were involved in this prospective study between September 2005 and September 2006 with 93 full-term babies. All the patients were evaluated for pregnancy period, birth, Apgar scores, blood gases, organ failure, clinical findings, anticonvulsant treatment, hospital stay, prognosis, and modified Sarnat and Sarnat staging. Incidence of HIE was 0.26% in 19,857 live births in the same hospitals and 1.2% of the patients in the NICUs. One minute mean Apgar score of the babies was 3.4 ± 2.7. Mean pH value and BE value in the first hour of life were 7.00 ± 0.19 and -14.5 ± 8.1, respectively. 67.8% of patients had convulsion in the first week of life. The most frequently affected organs were kidneys (39.8%), cardiovascular system and hepatic system. According to modified Sarnat and Sarnat staging, 28 (30.1%) patients were in Stage I, 36 (38.7%) in Stage II and 29 (31.2%) in Stage III. Mean hospital stay was 15.5 ± 18.5 days. Twenty-one (22.6%) of the patients died, and there was a statistically significant difference in mortality between stages (p<0.001). These results show that HIE has a low incidence but high mortality. However, as the study covered only university hospitals, a further study involving hospitals affiliated with the Ministry of Health will allow us to study more patients and to determine the accurate incidence. Anahtar Kelimeler : hipoksik iskemik ensefalopati, risk faktörleri, insidans, prognoz, Türkiye.
hypoxic ischemic encephalopathy, risk factors, incidence, prognosis, Turkey.
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