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Войти в исследования Journal of perinatology : official journal of the California Perinatal Association · 2025
Association of low hospital birth volume and adverse short-term outcomes for neonates treated with therapeutic hypothermia in rural states.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Craig Alexa K, Cutler Anya, Kerecman Jay, Melendi Misty, Seften Leah Marie, Ryzewski Matthew, Zanno Allison, O'Reilly Deirdre
Аннотация
OBJECTIVE: We hypothesized that outborn neonates in three rural states would have more frequent adverse short-term outcomes following therapeutic hypothermia (TH).
STUDY DESIGN: Multicenter retrospective study comparing outcomes for low (<500 births/year), medium (501-1500 births/year), and high (>1500 births/year) birth volume hospitals in Northern New England. Multivariable logistic regression assessed the combined outcome of death/severe gray matter injury on MRI, controlling for encephalopathy severity and time to initiation of TH.
RESULTS: Death occurred for 35/531 neonates: 15/120 (12%) low, 7/193 (4%) medium, and 13/218 (6%) for high birth volume hospitals (p = 0.008). Severe gray matter injury occurred in 8%, 6% and 7% of low, medium, and high birth volume hospitals, respectively (p = 0.7). Odds of the combined outcome were 4.3-fold higher in low versus high volume hospitals (95% CI = 1.6, 12.1, p = 0.004).
CONCLUSION: Neonates born in low volume birth hospitals had significantly higher odds of death following treatment with TH.
STUDY DESIGN: Multicenter retrospective study comparing outcomes for low (<500 births/year), medium (501-1500 births/year), and high (>1500 births/year) birth volume hospitals in Northern New England. Multivariable logistic regression assessed the combined outcome of death/severe gray matter injury on MRI, controlling for encephalopathy severity and time to initiation of TH.
RESULTS: Death occurred for 35/531 neonates: 15/120 (12%) low, 7/193 (4%) medium, and 13/218 (6%) for high birth volume hospitals (p = 0.008). Severe gray matter injury occurred in 8%, 6% and 7% of low, medium, and high birth volume hospitals, respectively (p = 0.7). Odds of the combined outcome were 4.3-fold higher in low versus high volume hospitals (95% CI = 1.6, 12.1, p = 0.004).
CONCLUSION: Neonates born in low volume birth hospitals had significantly higher odds of death following treatment with TH.