[Epidemiological trends 1992-2007 in a neonatal intensive care unit]. / Cambios epidemiológicos de 1992 a 2007 en una unidad de cuidados intensivos neonatales.

ABSTRACT

INTRODUCTION: progressive advances in neonatal care are expected to change the epidemiological profile of patients and conditions seen in neonatal intensive care units (NICU). Thus, the objective of this study was to identify such changes in a NICU in Mexico City. METHODS: retrospectively, we analyzed age, gender, weight at admission, hospital stay,diagnoses at discharge and cause of death in 5,192 patients admitted from 1992-2007. RESULTS: in the study period,patients were admitted at a progressively older age (median of 3 days old in 1992 to 9 in 2007; rS = 0.87) and lower weight (2,800-2,343 g; rS = ­0.56), while length of hospital stay was stable (approximately, 9 days). Over 90% patients had cardiological, digestive and/or pulmonary diseases, and most patients (71.4%) had conditions for which a surgical approach is the usual treatment. Cardiological and neurologic problems increased (rS = 0.86 and 0.85, respectively),while pulmonary diseases decreased (rS = ­0.79). Mortality and autopsy rate diminished from 26 to 15% (rS = ­0.80),and from 32.5 to 10.7% (rS = ­0.53), respectively. Conditions more frequently associated with death were urologic/nephrologic and infectious diseases. CONCLUSION: epidemiological patterns in our NICU are clearly changing, and thus searching for similar time trends in other NICU is warranted.