Inter-center variation in death or tracheostomy placement in infants with severe bronchopulmonary dysplasia.
J Perinatol
; 37(6): 723-727, 2017 06.
Article
em En
| MEDLINE
| ID: mdl-28181997
ABSTRACT
OBJECTIVE:
To estimate the presence and sources of inter-center variation (ICV) in the risk of death or tracheostomy placement (D/T) among infants with severe bronchopulmonary dysplasia (sBPD)Studydesign:
We analyzed the Children's Hospitals Neonatal Database between 2010 and 2013 to identify referred infants born <32 weeks' gestation with sBPD. The association between center and the primary outcome of D/T was analyzed by multivariable modeling. Hypothesized diagnoses/practices were included to determine if these explained any observed ICV in D/T.RESULTS:
D/T occurred in 280 (20%) of 1383 eligible infants from 21 centers. ICV was significant for D/T (range 2-46% by center, P<0.001) and tracheostomy placement (n=187, range 2-37%, P<0.001), but not death (n=93, range 0-19%, P=0.08). This association persisted in multivariable analysis (adjusted center-specific odds ratios for D/T varied 5.5-fold, P=0.009).CONCLUSIONS:
ICV in D/T is apparent among infants with sBPD. These results highlight that the indications for tracheostomy (and subsequent chronic ventilation) remain uncertain.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Displasia Broncopulmonar
/
Traqueostomia
/
Unidades de Terapia Intensiva Neonatal
/
Lactente Extremamente Prematuro
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article