[Hospital morbidity and mortality of children less than 1 year old in Riberão Preto, SP (Brazil), 1975]

Perfil de morbidade de crianças hospitalizadas em um hospital público: implicações para a Enfermagem

Objetivou-se conhecer as causas de hospitalização de crianças menores de cinco anos num hospital público no Paraná, para subsidiar as ações de enfermagem. Realizou-se uma pesquisa quantitativa, descritiva, exploratória, com análise estatística inferencial. Foram analisados 722 prontuários, no período de 2005-2009. Observou-se que menores de um ano tiveram mais hospitalizações (42%) do que os de um a cinco anos; maioria de internações do sexo masculino (65%); doenças respiratórias predominaram (56%) em relação ao conjunto das demais; tempo médio de internação de 9,4 dias para menores de um ano e 8,3 dias para menores de cinco anos; 95% tiveram alta hospitalar como desfecho. Esse perfil auxilia a direcionar o cuidado de enfermagem, incorporando os dados no planejamento, tanto na atenção básica quanto no hospital.

Hospitalizations during infancy in three population-based studies in Southern Brazil: trends and differentials

Three cohort studies of children born in the urban area of Pelotas, Southern Brazil, were carried out in 1982, 1993, and 2004. The aim of these studies was to measure the occurrence of hospitalization in the first year of life and to examine the association between hospitalization and the cause of admission and sex, birth weight, and family income. Cause of admission was categorized as "diarrhea" and "all other causes". The frequency of children hospitalized at least once during their first year of life was 19.6% in 1982, 18.1% in 1993, and 19.2% in 2004. There was a marked reduction in hospitalizations due to diarrhea, but the frequency of hospitalization for all causes remained constant. In all three cohorts, infants from poorer families and those born weighing under 2,000g showed the highest frequencies of hospitalization due to diarrhea and all other causes, and the latter also showed a marked increase in hospitalizations due to all causes. These findings could be explained by an epidemic of preterm births in the study population.

[Hospital morbidity in a county of Southern Brazil in 1992]

The distribution of the 2,518 admissions obtained in a sample taken from all the admissions which occurred in the eight general hospitals of the city of Maringá, State of Paraná, Brazil, in 1992 was analysed. The study variables were: main diagnosis, sex, age, city of residence, sources of financing, length of stay and discharge type. The leading causes of hospitalization were (ICD-9): complications of pregnancy, childbirth and puerperium and diseases of the respiratory and circulatory systems. Of the admissions, 42.8% were of men and when age adjusted, the highest proportion was found to be of children below 4 years of age. In the study, 64.4% were residents in Maringá, 24.9% lived in the 15th Region of Paraná and 8.7% lived out side the 15th Region of Paraná. The official Health System (SUS) was responsible for financing 73.8% of all admissions, private health insurances accounted for 14.9% and 11.3% of the patients were paying for their own hospital treatment. A difference was detected among the frequencies of the diagnoses according to financial support and city of residence. The average length of stay was 3.6 days and the hospital mortality rate was 2.7 deaths per hundred admissions.

[Prognostic factors of hospital mortality from diarrhea or pneumonia in infants younger than 1 year old. A case-control study]

Diarrhea and pneumonia are common diseases in children aged under one year, for which there are simple therapeutic measures. However, infant mortality due to these diseases is still very high, varying markedly according to socio-economic status. The characteristics of children who died (cases) and of those who were hospitalized with diarrhea or pneumonia, but survived (controls), were studied. The following groups of variables were studied: socio-economic, environmental and biological conditions, nutritional status and breast-feeding. Information on cases and controls was collected from hospital records and through home interviews. Important losses occurred in the latter: 40% of cases and 50% of controls were not interviewed. There were no significant differences between cases who were included and those who were not, in terms of age, sex or place of residence. To estimate relative risks of prognostic factors unconditional Logistic Regression was used to calculate the odds ratios and their 95% confidence intervals. Prematurity, low birth weight, weight/age deficit, presence of edema and poor general status at hospital admission were prognostic factors for hospital case-fatality. In relation to the anthropometric variables, it was not possible to conclude for certain whether the increased case-fatality was linearly or non-linearly (threshold) associated with nutritional deficit. The duration of breast-feeding was only associated with case-fatality for pneumonia. Socio-economic factors were not important for the prognosis of children admitted to hospital with diarrhea or pneumonia. Some of the expected risk factor associations were not detected, maybe due to the small sample size (resulting from the high losses) which was insufficient to show small differences. In this study the biological conditions of children with diarrhea or pneumonia appeared to be the important prognostic factors for hospital case-fatality.