Factores de riesgo asociados a muerte en niños de un mes a cinco años en el Hospital del Niño "Dr. Ovidio Aliaga Uría". La Paz - Bolivia
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Rev. bol. ped.
Abstract
Objetivo: identificar los factores de riesgo asociados a muerte en niños de un mes a menores de cinco años en el Hospital del Niño de la ciudad de La Paz, Bolivia. Diseño: estudio de casos y controles incidentes y prevalentes Lugar: hospital del Niño, de tercer nivel y referencia nacional Participantes: desde el 1 de Mayo al 30 de noviembre se admitieron 82 niños de un mes a menores de cinco años de edad, de los cuales 41 fallecieron (casos) y 41 niños dados de alta a continuación de cada caso (controles) Intervención: ninguna. Mediciones principales: recolección de datos de historias clínicas de casos y controles, con información general, diagnostico, causa de muerte, estados co-mórbidos, procedimientos practicados, día y hora de fallecimiento. Resultados: el 62% de las muertes se debieron a procesos infecciosos, seguidos de accidentes y traumas 12%, El 40% de las muertes ocurrieron en días feriados y fin de semana. En el análisis bivariado los principales Odds Ratios fueron los estados co-mórbidos como alteraciones hidroelectrolíticas OR 23 (IC95% 5.48-111.15), desnutrición severa OR 16 (IC95% 3-98), anemia por debajo de 80g/L OR 10 (IC95% 2.75- 38.58). Conclusiones: como en varios países subdesarrollados sin la transición epidemiológica aún las causas infecciosas son causa importante de muerte en menores de cinco años. Algunos factores asociados a muerte son susceptibles de intervenirse en el Hospital, como la intervención oportuna de algunos estados asociados a la enfermedad (anemia, alteraciones hidroelectrolíticas, metabólicas, ácido base), los otros factores encontrados dependen de mejorar el estado nutricional, intensificar campañas de vacunación.
Objective: to identify risk factors associated to death in children from one month to younger than five years in the Hospital del Niño, La Paz, Bolivia. Design: case control study Place: Hospital del Niño, third level and national reference center. Participants: from May 1 to November 30, 82 children admitted from one month to younger than five years of age, of which 41 died (cases) and 41 surviving children's after each case (control) Intervention: None Main mensurations: data of clinical histories of cases and controls, with general information, diagnose, cause of death, co-morbid states, practiced procedures, day and time of death. Results: 62% of deaths were due to infectious processes, followed by accidents and traumas 12%, 40% of deaths happened in holidays and weekends. In the analysis the main Odd Ratio was the co-morbid states as alterations hydroelectrolítics OR 23 (IC95% 5.48-111.15), severe malnutrition OR 16 (IC95% 3-98), anemia below 80g/L OR 10 (IC95% 2.75 - 38.58). Conclusions: as in several underdeveloped countries without the epidemic transition infectious causes are still an important cause of death in children under five years. Some factors associated to death are susceptible to change in the hospital, as the opportune intervention of some states associated to the illness (anemia, alterations hydroelectrolítics, metabolic, acid base), the other opposing factors depend on improving the nutritional state, to intensify vaccination campaigns.
Objective: to identify risk factors associated to death in children from one month to younger than five years in the Hospital del Niño, La Paz, Bolivia. Design: case control study Place: Hospital del Niño, third level and national reference center. Participants: from May 1 to November 30, 82 children admitted from one month to younger than five years of age, of which 41 died (cases) and 41 surviving children's after each case (control) Intervention: None Main mensurations: data of clinical histories of cases and controls, with general information, diagnose, cause of death, co-morbid states, practiced procedures, day and time of death. Results: 62% of deaths were due to infectious processes, followed by accidents and traumas 12%, 40% of deaths happened in holidays and weekends. In the analysis the main Odd Ratio was the co-morbid states as alterations hydroelectrolítics OR 23 (IC95% 5.48-111.15), severe malnutrition OR 16 (IC95% 3-98), anemia below 80g/L OR 10 (IC95% 2.75 - 38.58). Conclusions: as in several underdeveloped countries without the epidemic transition infectious causes are still an important cause of death in children under five years. Some factors associated to death are susceptible to change in the hospital, as the opportune intervention of some states associated to the illness (anemia, alterations hydroelectrolítics, metabolic, acid base), the other opposing factors depend on improving the nutritional state, to intensify vaccination campaigns.
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Vol. 43, No. 1