The chance of spontaneous patent ductus arteriosus closure in preterm infants born before 32 weeks of gestation is high and continues to increase until 5 years of follow-up.

AIM: The primary aim was to estimate premature infants' spontaneous patent ductus arteriosus closure rate. Secondly, to identify criteria associated with the chance of spontaneous closure. METHODS: We performed a retrospective cohort study of 167 infants born before 32 weeks of gestation and diagnosed with a patent ductus arteriosus between 1 January 2008 and 31 December 2017. The spontaneous patent ductus arteriosus closure event rate was evaluated using the Kaplan-Meier estimator. RESULTS: The spontaneous closure rate within the first year of life was 66% (95% CI 58%-73%), increasing to 80% (95% CI 72%-86%) five years after birth. When including both spontaneous closure and closure following treatment, 96% (95% CI 86%-100%) closed within 5 years after birth. The chance of spontaneous closure was reduced in the case of a large patent ductus arteriosus: OR 0.16 (95% CI 0.05-0.52), left atrial enlargement: OR 0.16 (95% CI 0.05-0.51), and pulmonary hypertension: OR 0.23 (95% CI 0.07-0.74). CONCLUSION: The chance of spontaneous closure in premature infants born between 23 and 32 weeks of gestation was high, and the incidence continued increasing until 5 years of follow-up.

Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high - a register-based Danish cohort study.

BACKGROUND: The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions, but the mortality has only scarcely been studied. The aim of this study was to examine the most frequent sub-diagnoses among patients with hospital non-specific diagnoses after calling 112 and their subsequent mortality. METHODS: A historical cohort study of patients brought to the hospital by ambulance after calling 112 in 2007-2014 and diagnosed with a non-specific diagnosis, chapter R or Z, in the International Classification of Diseases, 10th edition (ICD-10). 1-day and 30-day mortality was analyzed by survival analyses and compared by the log-rank test. RESULTS: We included 74,847 ambulance runs in 53,937 unique individuals. The most frequent diagnoses were 'unspecified disease' (Z039), constituting 47.0% (n 35,279). In children 0-9 years old, 'febrile convulsions' was the most frequent non-specific diagnosis used in 54.3% (n 1602). Overall, 1- and 30-day mortality was 2.2% (n 1205) and 6.0% (n 3258). The highest mortality was in the diagnostic group 'suspected cardiovascular disease' (Z035) and 'unspecified disease' (Z039) with 1-day mortality 2.6% (n 43) and 2.4% (n 589), and 30 day mortality of 6.32% (n 104) and 8.1% (n 1975). CONCLUSION: Among patients calling an ambulance and discharged with non-specific diagnoses the 1- and 30-day mortality, despite modest mortality percentages lead to a high number of deaths.