Thrombocytopenia in neonates and the risk of intraventricular hemorrhage a retrospective cohort study 英文参考文献.docVIP

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Thrombocytopenia in neonates and the risk of intraventricular hemorrhage a retrospective cohort study 英文参考文献.doc

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Thrombocytopenia in neonates and the risk of intraventricular hemorrhage a retrospective cohort study 英文参考文献

vonLindern etal.BMCPediatrics2011,11:16 /1471-2431/11/16 RESEARCH ARTICLE OpenAccess Thrombocytopeniainneonatesandtheriskof intraventricularhemorrhage:aretrospective cohortstudy JeannetteSvonLindern 1,2*?,TjitskevandenBruele1,2?,EnricoLopriore1,FransJWalther1 Abstract Background:Theoverallprevalenceofthrombocytopeniainneonatesadmittedtoneonatalintensivecareunits rangesfrom22to35%.Thereareonlyafewsmallstudiesthatoutlinetherelationshipbetweentheseverityof thrombocytopeniaandtheriskofbleeding.Thismakesitdifficulttoformanevidence-basedthresholdforplatelet transfusionsinneonatalpatients.Theaimofthisstudywastodeterminetheprevalenceofthrombocytopeniaina tertiaryneonatalintensivecareunitandtostudytherelationbetweenthrombocytopeniaandtheriskof intraventricularhemorrhage(IVH). Methods:Weperformedaretrospectivecohortstudyofallpatientswiththrombocytopeniaadmittedtoour neonataltertiarycarenurserybetweenJanuary2006andDecember2008.Patientsweredividedinto4groups accordingtotheseverityofthrombocytopenia:mild(100-149×109/L),moderate(50-99×109/L),severe(30-49× 109/L)orverysevere(30×109/L).TheprimaryoutcomewasIVH≥grade2.Pearson’schi-squaredandFischer’s exacttestswereusedforcategoricaldata.ANOVA,logisticregressionanalysisandmultivariatelinearregression wereusedforcomparisonsbetweengroupsandforconfoundingfactors. Results:Theprevalenceofthrombocytopeniawas27%(422/1569).RiskofIVH≥grade2was12%(48/411)in neonateswithversus5%(40/844)inneonateswithoutthrombocytopenia(p0.01).Aftermultivariatelinear regressionanalysis,riskofIVH≥grade2inthesubgroupsofthrombocytopenicinfantswasnotsignificantly different(p=0.3). Afterlogisticregressionanalysisthedifferenceinmortalityrateinneonateswithandwithoutthrombocytopenia wasnotsignificant(p=0.4).Similarly,wefoundnodifferenceinmortalityrateinthesubgroupsofneonateswith thrombocytopenia(p=0.7). Conclusion:AlthoughIVH≥grade2occursmoreofteninneonateswiththrombocytopenia,thisrelationis independentoftheseverityofthrombocytopenia.Prospectivestudiesshouldbecondu