• Title/Summary/Keyword: Infant mortality

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Congenital Diaphragmatic Hernia and Eventration Requiring Operation in the first 24hrs of Life - A report of 5 cases - (생후 24 시간 이내에 수술을 요하는 선천성 횡경막 탈장 및 횡경막 내번증5례 보고)

  • Lee, Cheol-Beom;Hong, Gi-Ung;No, Jin-Sam
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.175-183
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    • 1988
  • Congenital diaphragmatic hernia [CDH] is a surgical emergency in the newborn infant because it causes severe cardiorespiratory distress. Congenital diaphragmatic eventration [CDE] may also produce severe cardiorespiratory distress in the newborn infant. CDH is an anatomically simple defect that can be easily repaired by reduction of the displaced viscera from the pleural cavity and closure of the diaphragmatic defect. But these infants mortality has not been reduced and still remains very high. The barrier to survival is pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persistent fetal circulation. Between May, 1985 and Oct, 1987, 4 neonates with CDH and 1 neonate with CDE were seen in respiratory distress within 12 hrs of birth at St. Francisco general hospital. Each had severe acidosis and hypoxia. And was transferred from a local clinic. They were surgically repaired within 24 hrs of birth. Three neonates lived and two died. Two of the three neonates with CDH operated in the first 6 hrs died. The remaining two [one with CDH, the other with CDE] operated between 6hrs and 24 hrs lived. One case of mortality was combined with bilateral pulmonary hypoplasia and contralateral pneumothorax. The other one case of mortality was combined with complex syndrome of persistent fetal circulation after honeymoon period.

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Knowledge on Sudden Unexplained Infant Death-related Safe Sleep Practices and Infant Cardiopulmonary Resuscitation in Pediatric Nurses

  • Cho, Jung Ae;Sohn, Min;Lee, Sangmi;Ahn, Young Mee
    • Child Health Nursing Research
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    • v.26 no.4
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    • pp.454-462
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    • 2020
  • Purpose: Sudden unexplained infant death (SUID) is a major contributor to infant mortality, and pediatric nurses have the responsibility to educate parents on SUID-reducing strategies. This study was conducted to measure pediatric nurses' knowledge of SUID-related safe sleep practices (K-SSSP) and infant cardiopulmonary resuscitation (K-ICPR). Methods: In total, 136 pediatric nurses were administered a survey including K-SSSP (13 items), K-ICPR (5 items), confidence in K-SSSP education (1 item; 5 points), and other factors relating to SUID experiences or education. Results: The correct answer rates of the K-SSSP and K-ICPR were 62.6% and 62.5%, retrospectively. The mean score for confidence in K-SSSP education was 2.6±0.9. Only 18 nurses (13.2%) responded that they educated parents on the content of the K-SSSP, while 76 nurses had received education on SUID. Positive relationships were observed between K-SSSP scores and higher education, between K-ICPR scores and having own child(ren) and clinical experience, and between confidence in K-SSSP education and higher education or having one's own child(ren). Nurses caring for newborns performed more SUID education than nurses working in other units. Conclusion: There is a profound need to implement a systemic educational program on SUID and strategies to reduce SUID for pediatric nurses.

Trends and Age-Sex Patterns of Mortality in Korea (한국사망율의 변동과 구조분석)

  • 김남일
    • Korea journal of population studies
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    • v.9 no.1
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    • pp.14-31
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    • 1986
  • This study shows trends and age-sex patterns of mortality in Korea, based on adjusted death registration data during 1956∼1980. Description on the data-the types of errors and their methods of adjustment-are presented elsewhere (Kim, 1986). Crude death rates have declined in 20 years to 7.0 in 1976∼1980, almost half the level of 13.0 in 1956∼1960. Mortality of females declined faster than males, especially at older ages. Substantial differences in provincial mortality are observed based on the expectation of life at birth. The difference between the highest and the lowest provinces is 9.2 years for males and 8.3 years for females during 1976∼1980. This study presents two interesting features of age-sex patterns of mortality in Korea. One feature is higher female mortality than males during childhood periods. However, infant mortality is higher for males than for females throughout the period, though the difference is much smaller than is expected from various model life tables. Another feature is the rapid rise in mortality for males after age 40. This pattern is found to be existed throughout the period 1956∼1980. Further studies are recommended to establish its causal linkage to traditional sex role (as main bread winner) and health behavior (smoking and drinking) of males and recent rapid industrialization in Korea.

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A Case of Midgut Volvulus with Gastric Perforation and Periveintricular Leukomalacia in a Term Infant

  • Park, Seul Gi;Hwang, Jong Hee
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.53-58
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    • 2021
  • Intestinal malrotation with midgut volvulus (MV) is a life-threatening surgical emergency. Most events of MV occur in the neonatal period with bilious vomiting, abdominal distension, feeding intolerance, and bloody stools. Neonatal gastric perforation (GP) is a rare and life-threatening condition associated with high mortality. It occurs either in an idiopathic form or in association with gastrointestinal anomalies such as duodenal atresia and MV. The pathogenesis of both MV and GP is related to ischemic change and inflammatory response. MV and GP can lead to morbidities such as sepsis, intestinal ischemia, and organ failure, but not neurologic problems. We herein report the case of a term infant at 5 days after birth, with MV accompanied by GP, who developed periventricular leukomalacia.

A Study of 80 Cases of Empyema (농흉의 임상적 고찰)

  • 김세화;곽문섭;주수동
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.41-49
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    • 1969
  • The authors made a clinical study of 80 cases of empyema who were diagnosed and treated at department of chest surgery, St. Mary`s Hospital, Chatholic Medical College, during the period of May.l964 through April.1969 and compared the empyema of infant and children with that of adults. 1. In age and sex ditribution, infant was 6 cases, childhood 22 cases and adult 52 cases. The ratio of male to female was 2.2:1. There`s a little difference in infant-childhood but prominence of males over females in adults was being 3. 3:1, in its ratio. 2. The cardinal symptoms were cough [61.3%], fever [60.0%] and dyspnea [52.8%]. The leukocytosis were observed in 83.7% of all cases, 96.2% of infant-childhood and 76.9% of adults. The hemoglobin level showed subnormal in 82.1% of infant-childhood and in 55.8% of adults. 3. Most frequent lesion to predisposing factor of empyema was pneumonia [43.7%],being prominent in infants children [64.3%] to that of adult 4. The Pathogenic organism by culture in 75 cases of empyema were staphylococuss [48%], streptococuss[9.3%], Gram[-] bacilli [9.3%], Klebsiella[2.7%], pneumococcus[4.0%], E. coli [5.4%] and no growth 21.3% in over all. Among the cases of empyema. staphlocal origin was 62.9% in infant-childfood and 39.6% adults. 5. Staphylococci were most susceptible to erythromycin [86. 1%], Kanamycin [75.0%], albamycin [61.7%] and neomycin [52.8%] but most resistant to penicillin, Chtoramphenicol and terramycin. 6. In the treatment of empyema, of 53 cases were closed thoracotomy drainage and the remainder of cases by open thoracotomy, decortication, thoracoplasty and pleuropneumonectomy. we could attain favourable results by only the closed thoracotomy in infant-childhood, 28 cases. 7. The mortality rate was 6.3% in over all; adult 3 cases, infant and children 2 cases. 3 cases of these, were due to staphylococcal infection.

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Clinical Study and Risk Factors of Surgical Mortality of Congenital Heart Defects (선천성 심장기형의 임상고찰 및 수술사망율에 미치는 위험인자의 분석)

  • 이상호;김병균
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.17-26
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    • 1997
  • Objeitives. The surgical mortality of congenital heart defects has been reduced (or the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Falloff. Some risk factors were analyzed Methods. Three hundred and sixty six patients underwent surgical Intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cyanotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. Results. The overall surgical mortality was 10.4%. Mos deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/101). Risk factors of mortality in open heart surgery were age(p< 0.0001), body weight(p< 0.0001), pump time(p< 0.0001), aortic cross clamp time(p< 0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding tetralogy of Falloff(odds ratio=0.27). Conclusions. Even though the most important risk factor was disease entity, we should conentrate our efforts on the technically improvable factors affecting surgical mortality indicated by univarlate analysis.

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Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease (선천성 심질환으로 고식적 수술을 시행 받은 영아의 홈모니터링의 성과)

  • Kim, Sang Wha;Uhm, Ju-Yeon;Im, Yu Mi;Yun, Tae-Jin;Park, Jeong-Jun;Park, Chun Soo
    • Journal of Korean Academy of Nursing
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    • v.44 no.2
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    • pp.228-236
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    • 2014
  • Purpose: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. Methods: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. Results: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (${\chi}^2$=1.15, p=.283). Conclusion: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.

Analysis of Infant Mortality Rate in Korea Concerning According to Birth Weight and Gestational Age from 2005 to 2009 (한국의 2005-2009년도 영아사망률 중에서 출생체중, 임신나이 별 구분에 따른 신생아 사망률의 비율 관찰)

  • Cho, Mi-Jin;Ko, Jin-Hee;Chung, Sung-Hoon;Choi, Yong-Sung;Hahn, Won-Ho;Chang, Ji-Young;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.182-188
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    • 2011
  • Purpose: Recently in Korea, there have been significant improvements in neonatal mortality rate (NMR) and infant mortality rate (IMR). This study aimed to investigate the proportion of the NMR among IMR, with the goal of discerning the influence of improved NMR on the reduction of IMR in the last 5 years in Korea. Methods: All data were from Statistics Korea. Changes in the NMR percentage among IMR and the percentage of the death by the distribution of the birth weight and gestational were investigated. Results: The total birth rate decreased, but the total number of preterm and low birth weight infants increased. These was a large decrease in NMR and IMR. The proportion of NMR among INR exceeded 50%. Early NMR was higher than late NMR. Among the total infant death, the mortality of preterm and low birth weight infants was high. Conclusion: Between 2005 and 2009, the total birth has declined in Korea, but the frequency of low birth weight infants is trending upward. The improvements in NMR and IMR, and the downtrend of the NMR percentage in IMR, are encouraging. It seems that the continued decrease of mortality of preterm and LBWI is required for better improvements NMR and IMR in Korea. This result is expected to be used for the basic data to improve the management of the newborns in Korea.

Regional Demographic Transition in Developing Countries (개발도상국에서의 출산력 변천 추이)

  • Chung, Sung-Ho
    • Korea journal of population studies
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    • v.28 no.2
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    • pp.183-203
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    • 2005
  • Over the past four decades reproductive behavior has changed rapidly in much of the developing countries. The average total fertility rate has fallen by half from six or more to near three today. Between 1960 and 2000 the largest fertility decline occurred in Asia and Latin America. The mortality rate has decreased in most developing countries. The purpose of this study is to review the pattern of demographic transition in developing countries. At first, this study focuses on the regional fertility transition. In Africa, the total fertility rate has decreased from 6.59 to 4.85 between 1960 and 2000. However, the rate has rapidly fallen from 5.76 to 2.34 in East Asia. The same pattern is found in Latin America. The mortality rate has also decreased in most of developing countries. It is also interesting to find that there is a clear difference among developing countries. In terms of crude death rate, Latin American countries show the lowest rate, while African countries remain still high rate. The study also shows the relationship between socioeconomic indicators and fertility/mortality in developing countries. The result supports the hypothesized relationship between education and fertility. However, the effects of urbanization and income on fertility do not show consistent result. About mortality rate, however, the study shows the significant relationship between urbanization and infant mortality rate, between income and mortality. The study finally emphasizes that we should include 'AIDS' in the study of mortality in African countries.

Construction of a Life Table for Infant and Childhood (영유아 생명표 작성에 관한 연구)

  • 김종석
    • Korea journal of population studies
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    • v.3 no.1
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    • pp.52-61
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    • 1979
  • The purpose of the study is to construct a life table for population. It is based on the fraction of last year of life, $a_X$. The data necessary for this purpose have been obtained from the 1975 Population Census Report of Korea and the Vital Statistics of Shindong-myon, Chunseong-gun, Gangwon Province which is collected for the Seoul National University public health program. Age specific death rate is adapted by the Model Life Table, West, Level 21. For the age groups of less than 5 years of age, when the record of vital events can be obtained, the fractions are calculated from the community vital statistics. And for the age groups older than 5 years of age, Greville's Method is used. The findings are summarized as follows: 1) The fraction of last year of life in infantile group is 0.3684 for males, 0.3711 for females, and in 1-4 years of age group 1.2164 for males, 1.2274 for females. Both are more than those of Japan and U.S. in 1963. 2) Infant mortality rate is 42.37 for males, 31.77 for females per 1,000 live births. 3) The mortality curves show that a higher rate is observed under 1 year of age. It drops to the lowest point at around 10 years of age and rises again as the age increases. 4) The age estimated half-survival rate is during the age group of 70-74 for both sexes. 5) Life expectancy at the age of 0 shows 65.73 years for males and 69.22 years for females.

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