Identification of important and potentially avoidable risk factors in a prospective audit study of neonatal deaths in a paediatric hospital in Vietnam

Alexandra Y Kruse, Cam N Phuong, Binh T T Ho, Lone G Stensballe, Freddy K Pedersen, Gorm Greisen

6 Citations (Scopus)

Abstract

AIM: Neonatal deaths (≤28 days) account for more than half of child mortality in Vietnam. Presumably most die in hospital, but data are scarce. This study aimed to identify risk factors of death among hospitalised neonates.

METHODS: We prospectively studied all neonatal deaths and expected deaths (discharged alive after withdrawal of life-sustaining treatment) in a Vietnamese tertiary paediatric hospital during a 12-month period in 2009-2010. The medical files were audited classifying admission prognosis, discharge outcome, cause of death/expected death according to two classifications, and important and potentially avoidable risk factors during the hospital stay.

RESULTS: Among 5763 neonates admitted, 235 deaths and 67 expected deaths were included. According to both classifications, major causes were congenital malformations, prematurity and severe infections. Six risk factors were identified in 85% (60/71) of the neonates with a relatively good prognosis: recognition or response to danger signs, internal transfers, nosocomial infections, sepsis management, access to usual equipment/staff, and family perception.

CONCLUSION: Among 302 neonatal deaths/expected deaths, the major causes were congenital malformations, prematurity and severe infections. Six important and potentially avoidable risk factors could be addressed in the subgroup with relatively good admission prognosis, without implementing new technology or major organisational changes.

Original languageEnglish
JournalActa paediatrica (Oslo, Norway : 1992)
Volume103
Issue number2
Pages (from-to)139-144
Number of pages6
ISSN0803-5253
DOIs
Publication statusPublished - Feb 2014

Keywords

  • Cause of Death
  • Congenital Abnormalities
  • Female
  • Hospital Mortality
  • Hospitals, Pediatric
  • Humans
  • Infant Mortality
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases
  • Infection
  • Male
  • Medical Audit
  • Prospective Studies
  • Risk Factors
  • Vietnam
  • Withholding Treatment

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