Is a higher altitude associated with shorter survival among at-risk neonates?

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dc.careerMedicinaes
dc.category.authorprincipalen_US
dc.contributor.authorArmijos Acurio, María Luciana
dc.contributor.authorDueñas Espin, Ivan Guillermo
dc.contributor.authorJimbo Sotomayor, Ruth Elizabeth
dc.contributor.authorRivadeneira Guerrero, María Fernanda
dc.contributor.authorTello Ponce, Betzabé Magdalena
dc.contributor.correspondingArmijos Acurio, María Luciana
dc.countryEcuadores
dc.date.accessioned2023-11-04T21:33:18Z
dc.date.available2023-11-04T21:33:18Z
dc.date.issued2021
dc.dedication.authorTCes
dc.description.abstractIntroduction: We hypothesize that high altitudes could have an adverse effect on neonatal health outcomes, especially among at-risk neonates. The current study aims to assess the association between higher altitudes on survival time among at-risk neonates. Methods: Retrospective survival analysis. Setting: Ecuadorian neonates who died at ≤28 days of life. Patients: We analyzed the nationwide dataset of neonatal deaths from the Surveillance System of Neonatal Mortality of the Ministry of Public Health of Ecuador, registered from 126 public and private health care facilities, between January 2014 to September 2017. Main outcome measures: We retrospectively reviewed 3016 patients. We performed a survival analysis by setting the survival time in days as the primary outcome and fixed and mixed-effects Cox proportional hazards models to estimate hazard ratios (HR) for each altitude stratum of each one of the health care facilities in which those neonates were attended, adjusting by individual variables (i.e., birth weight, gestational age at birth, Apgar scale at 5 minutes, and comorbidities); and contextual variables (i.e., administrative planning areas, type of health care facility, and level of care). Results: Altitudes of health care facilities ranging from 80 to <2500 m, 2500 to <2750m, and ≥2750 m were associated respectively with 20% (95% CI: 1% to 44%), 32% (95% CI:<1% to 79%) and 37% (95% CI: 8% to 75%) increased HR; compared with altitudes at <80 m.en_US
dc.facultyMedicinaes
dc.id.author1711422152
dc.id.author1715382378
dc.id.author1103364947
dc.id.author1711111185
dc.id.author1711224467
dc.id.type1
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0253413
dc.identifier.issn1932-6203
dc.identifier.urihttps://repositorio.puce.edu.ec/handle/123456789/5159
dc.identifier.urihttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253413
dc.indexed.databaseScimago Journal Rankes
dc.language.isoen
dc.list.authorsDueñas, I., Armijos, L., Espín, E., Espinosa, F., Jimbo, R., León, Á., Nasre, R., Rivadeneira, M., Rojas, D., Ruiz, L., Tello, B., & Vásconez, D.
dc.magazine.pageRangee0253413
dc.magazine.titlePLoS ONEes
dc.magazine.volumeChapter16(7)
dc.rightsOpenAccessen
dc.statepublisheden_US
dc.subjectNeonatologíaes
dc.subjectMortalidad infantiles
dc.subjectNeonatología
dc.subjectMortalidad infantil
dc.titleIs a higher altitude associated with shorter survival among at-risk neonates?en_US
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