DIABETIC KETOACIDOSIS IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS AND ASSOCIATED RISK FACTORS

Objective: to estimate the prevalence and risk factors of diabetic ketoacidosis in children and adolescents with Type 1 Diabetes Mellitus.Method: an epidemiological, cross-sectional and cohort study that analyzed the medical charts of children and adolescents with Type 1 Diabetes Mellitus admitted over a 10-year period to a public reference hospital in the municipality of Campina Grande, Brazil, from 2009 to 2019. The data were analyzed by means of descriptive statistics, both bivariate and multivariate through Poisson regression.Results: 130 medical charts were analyzed, of which 46.2% presented diabetic ketoacidosis. The independent variables that significantly and jointly impacted on the outcome were the following: age, infection, diet error and error in insulin dosage.Conclusion: diabetic ketoacidosis was a common finding in children and adolescents with Type 1 Diabetes Mellitus. The results contribute to Nursing care and allow implementing intervention for the prevention and adequate management of the problem.Objective: to estimate the prevalence and risk factors of diabetic ketoacidosis in children and adolescents with Type 1 Diabetes Mellitus.Method: an epidemiological, cross-sectional and cohort study that analyzed the medical charts of children and adolescents with Type 1 Diabetes Mellitus admitted over a 10-year period to a public reference hospital in the municipality of Campina Grande, Brazil, from 2009 to 2019. The data were analyzed by means of descriptive statistics, both bivariate and multivariate through Poisson regression.Results: 130 medical charts were analyzed, of which 46.2% presented diabetic ketoacidosis. The independent variables that significantly and jointly impacted on the outcome were the following: age, infection, diet error and error in insulin dosage.Conclusion: diabetic ketoacidosis was a common finding in children and adolescents with Type 1 Diabetes Mellitus. The results contribute to Nursing care and allow implementing intervention for the prevention and adequate management of the problem

CETOACIDOSIS DIABÉTICA EN NIÑOS Y ADOLESCENTES CON DIABETES MELLITUS TIPO 1 Y FACTORES DE RIESGO ASOCIADOS

Objetivo: estimar la prevalencia y los factores de riesgo de la cetoacidosis diabética en niños y adolescentes con Diabetes Mellitus tipo 1.Método: estudio epidemiológico de cohorte transversal en el que se analizaron historias clínicas de niños y adolescentes con Diabetes Mellitus tipo 1 internados en un período de 10 años en un hospital público de referencia del municipio de Campina Grande, Brasil, entre 2009 y 2019. Los datos se recolectaron por medio de estadística descriptiva, bivariada y multivariada por regresión de Poisson.Resultados: se analizaron 130 historias clínicas, de las cuales el 46,2% presentó cetoacidosis diabética. Las variables independientes que afectaron en forma significativa y conjunta el desenlace fueron las siguientes: edad, infección, error en la dieta y error en la posología de insulina.Conclusión: la cetoacidosis diabética fue un hallazgo común entre niños y adolescentes con Diabetes Mellitus tipo 1. Los resultados contribuyen a la atención de Enfermería y permiten implementar intervenciones para la prevención y el manejo adecuado del problema

Incidence of neonatal near miss in a midsize maternity in the Northeast Brazil

Objetivo: Verificar a incidência de near miss neonatal (NMN), indicador de “quase morte” por complicações pré ou pós-natais, em uma maternidade de médio porte no Nordeste brasileiro. Modelo do estudo: Coorte retrospectiva, com abordagem indutiva e procedimentos descritivos. Metodologia: Analisou-se prontuários de nascidos no mês de janeiro de 2016, identificando-se os casos de NMN conforme os seguintes critérios: idade gestacional < 32 semanas, recém-nascido (RN) que necessitou de manobra de reanimação ou deprimido, peso ao nascimento < 1500 g, necessidade de cuidados em unidade de terapia intensiva neonatal (UTIN), necessidade de ventilação mecânica, escore de Apgar no 1º e 5º minutos < 7. Para verificar a associação entre as variáveis maternas e o diagnóstico de NMN, foi utilizado o teste t de Student. Resultados: Foram avaliados 120 RN. Dentre eles, 26 nascidos de parto normal e 94 de parto cesáreo. A média de idade materna foi de 26,61 (±7,9). A maioria das genitoras apresentava doenças cardiovasculares (71,7%) e 70,8% pré-natal com número de consultas inferior a sete. Identificou-se uma incidência de 30% de NMN, sendo a maioria do sexo masculino (55%). A taxa de internação na UTIN foi de 17,5%. O menor número de filhos vivos e médias superiores de partos cesáreos apresentaram associação significativa (p < 0,05) com o NMN. Conclusão: O indicador de NMN apresentou uma elevada incidência, mesmo em hospital de referência para gestação de alto risco, sendo um método de grande relevância para avaliação e prevenção de morbidades graves do RN.Objective: Verifying the incidence of neonatal near miss (NNM), an indicator of "near-death" due to pre or postnatal complications, in a medium-sized maternity hospital in the Northeast of Brazil. Study model: retrospective cohort, with an inductive approach and descriptive procedures. Method: Birth charts were analyzed during January 2016, and NNM cases were identified according to the following criteria: gestational age < 32 weeks, newborn (NB) requiring resuscitation or depressed maneuver, birth weight < 1500 g, need for care in a neonatal intensive care unit (NICU), need for mechanical ventilation, Apgar score at 1 and 5 minutes ≤ 7. To verify the association between maternal variables and NMN diagnosis the Student's t-test was used. Results: 120 NB were evaluated. Among them, 26 born of normal birth and 94 of cesarean delivery. The mean maternal age was 26.61 (± 7.9). The majority of the mothers had cardiovascular diseases (71.7%) and 70.8% had a prenatal visit with several consultations below seven. An incidence of 30% of NNM was observed, most of them male (55 %). The hospitalization rate in the NICU was 17.5%. The lower number of live children and higher mean cesarean births had a significant association (p <0.05) with the NNM. Conclusion: The NNM indicator presented a high incidence, even in a reference hospital for a high-risk pregnancy, being a highly relevant method for the evaluation and prevention of severe morbidity in the NB