Determinants of Mortality in a Neonatal Intensive Care Unit in Athens, Greece: A Case-Control Study

Introduction: The aim of this study was to investigate associations between death and sociodemographic and clinical determinants in a neonatal ICU (NICU) in Athens, Greece, by means of a case-control study. Methods: The study was conducted between January 2013 and October 2017 at the NICU of “Panayiotis & Aglaia Kyriakou” Children’s Hospital in Athens, Greece. The NICU subjects that died (case group) during this period (n=49) were compared with a control group of 451 NICU-admitted subjects who survived, during the same period. Potential determinants of mortality were assessed; univariate and multivariate logistic regression analysis was performed; odds ratios (OR) and 95% confidence intervals (95% CIs) were estimated. Results: Gestational age less than 32 weeks (adjusted OR=4.59, 95%CI: 2.09-10.10), low birth weight (adjusted OR=3.14, 95%CI: 1.43-6.91), emergency transfer (adjusted OR=11.92, 95%CI: 1.57-90.60), cyanosis (adjusted OR=5.20, 95%CI: 2.25-12.01), perinatal asphyxia (adjusted OR=6.96, 95%CI: 3.07-15.75), necrotizing enterocolitis (adjusted OR=3.21, 95%CI: 1.03-9.99), need for oxygen supply, and incubator use emerged as independent predictors of mortality. Conclusion: Extreme prematurity, low birth weight, necrotizing enterocolitis, and emergency conditions are associated with mortality, despite progress made in the field of neonatal intensive care.