Rahela N Abbasey, Mahmood Jame.
Factors affecting the outcome in babies with hypoxic Ischemic Encephalopathy.
Ann Pak Inst Med Sci Jan ;2(3):158-62.

[s] Objective: To find out the percentage of cases of hypoxic ischemic encephalopathy in neonates admitted in a tertiary care centre and the developmental/neurologic outcome of the survivors. Place and Duration of Study: This observational study was conducted at the Department of Neonatology Children`s Hospital, Pakistan Institute of Medical Sciences, Islamabad from 1st June 1997 to 31st Dec 1997. Subject and Methods: Sixty three babies fulfilled the criteria for hypoxic ischemic encephalopathy. Demographic indicators, clinical symptoms and signs of the cases were recorded. The classification into different stages of hypoxic ischemic encephalopathy was carried out according to Sarnet and Sarnet criteria from the day of admission. On outcome basis, cases were divided into two groups, survivors and those who expired. Different variables affecting both groups were compared. The survivors of hypoxic ischemic encephalopathy were later followed up for one year at Children`s Hospital, Pakistan Institute of Medical Sciences and any neurological or developmental sequelae were recorded. Result: The percentage of hypoxic ischemic encephalopathy in admitted cases was 11%. Thirty-six patients were discharged (57.1%) while 27(42.9%) expired. According to Sarnet staging done within the first 48 hours of life, twenty-nine infants were in stage I (46%), twenty-one (33.3%) were in stage II and thirteen (20.6%) were in stage III. On comparing different variables of the two groups, Sarnet staging was found to be a good predictor of outcome (p. value <0.000) RR 8.8. Five minute Apgar score was also significant with p.value <0.05. On follow up of survivors, neurological deficit was found in two cases (6.4%). Conclusion: Hypoxic ischemic encephalopathy is a common reason for hospital admission among neonates. Sarnet and Sarnet staging is a good predictor for outcome. Moreover, the babies with birth asphyxia require long-term neurological follow up in order to identify any developmental, motor or cognitive defect.

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