Competing Risk Analysis of the Health Status of Neonates with Respiratory Distress Syndrome
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Date
2020-06-29
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Addis Ababa University
Abstract
Respiratory distress syndrome (RDS) is not only the most common respiratory disorder in premature infants but also the main cause of neonatal mortality. Data from a study of illness in preterm project collected from neonatal intensive care units (NICUs) of five selected hospitals in Ethiopia during July 1, 2016, to May 31, 2018, were used to examine and identify potential prognostic factors of the health status of preterm infants with respiratory distress syndrome by considering the competing risk framework. Preterm infants admitted to NICU of the selected hospitals were followed for 28 days and only neonates with complete cases and RDS problems were included in the analysis. The Fine-Gray or sub-distribution hazard model was used to identify significant prognostic factors. Three outcome variables (death due to RDS, death due to other causes and discharged alive) were considered and the Fine-Gray model was fitted for each outcome variable separately. Anemia, multiple pregnancies, birthweight, and gestational age were the potential prognostic factors significantly associated with the death of neonates due to Respiratory distress syndrome problem. Pneumonia, meningitis, anemia, and gestational age of neonates were the significant prognostic factors for the death of neonates due to other causes. Moreover, pneumonia, birthweight, and gestational age were identified as the prognostic factors associated with being discharged alive of the neonates. Offering intensive and adequate treatments for most critically exposed neonates with lowest birth-weight (less than 1000g) and gestational age (less than 28 weeks) may be useful to decrease the burden of neonatal mortality and increase the incidence of being discharged alive.
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Keywords
Competing Risk Analysis, Health Status, Neonates with Respiratory, Distress, Syndrome