OBJECTIVE: Current scoring systems, which adjust prediction for severity of illness, do not account for higher observed mortality in neonatal intensive care units (NICUs) of children's hospitals than that of perinatal centers. We hypothesized that three potential predictors, (a) admission from another NICU, (b) presence of congenital anomalies and (c) need for surgery, would modify expected mortality and/or length of stay for infants admitted to NICUs in children's hospitals. STUDY DESIGN: We reviewed consecutive admissions to two NICUs in children's hospitals in Canada. We performed regression analyses to evaluate these potential predictors and severity-of-illness indices for the outcomes of mortality and length of stay. RESULT: Of 625 neonatal admissions, transfer from another NICU, congenital anomalies requiring admission and surgery were identified in 371 (59%). Using logistic regression, mortality was predicted based on admission from another NICU (odds ratio (OR) 1.92; 95% confidence interval (CI) 1.04, 3.57), congenital anomalies (OR 7.28; 95% CI 3.69, 14.36) and a validated severity-of-illness score, the Score for Neonatal Acute Physiology Perinatal Extension Version II (SNAPPE-II; OR 1.07; 95% CI 1.05, 1.09 per point). By contrast, surgical intervention was predictive of survival (OR 0.35; 95% CI 0.18, 0.67). Length of stay >or=21 days was predicted by SNAPPE-II (OR 1.02; 95% CI 1.01, 1.03 per point), congenital anomalies (OR 2.47; 95% CI 1.60, 3.79) and surgery (OR 2.73; 95% CI 1.77, 4.21). CONCLUSION: Fair performance comparisons of NICUs with different case-mixes, such as children's hospital and perinatal NICUs, in addition to severity-of-illness indices, should account for admissions from another NICU, congenital anomalies and surgery.
OBJECTIVE: Current scoring systems, which adjust prediction for severity of illness, do not account for higher observed mortality in neonatal intensive care units (NICUs) of children's hospitals than that of perinatal centers. We hypothesized that three potential predictors, (a) admission from another NICU, (b) presence of congenital anomalies and (c) need for surgery, would modify expected mortality and/or length of stay for infants admitted to NICUs in children's hospitals. STUDY DESIGN: We reviewed consecutive admissions to two NICUs in children's hospitals in Canada. We performed regression analyses to evaluate these potential predictors and severity-of-illness indices for the outcomes of mortality and length of stay. RESULT: Of 625 neonatal admissions, transfer from another NICU, congenital anomalies requiring admission and surgery were identified in 371 (59%). Using logistic regression, mortality was predicted based on admission from another NICU (odds ratio (OR) 1.92; 95% confidence interval (CI) 1.04, 3.57), congenital anomalies (OR 7.28; 95% CI 3.69, 14.36) and a validated severity-of-illness score, the Score for Neonatal Acute Physiology Perinatal Extension Version II (SNAPPE-II; OR 1.07; 95% CI 1.05, 1.09 per point). By contrast, surgical intervention was predictive of survival (OR 0.35; 95% CI 0.18, 0.67). Length of stay >or=21 days was predicted by SNAPPE-II (OR 1.02; 95% CI 1.01, 1.03 per point), congenital anomalies (OR 2.47; 95% CI 1.60, 3.79) and surgery (OR 2.73; 95% CI 1.77, 4.21). CONCLUSION: Fair performance comparisons of NICUs with different case-mixes, such as children's hospital and perinatal NICUs, in addition to severity-of-illness indices, should account for admissions from another NICU, congenital anomalies and surgery.
Authors: J Kurian; J Mathew; K Sowjanya; K R K Chaitanya; M Ramesh; J Sebastian; D Narayanappa Journal: Indian J Pediatr Date: 2016-02-26 Impact factor: 1.967
Authors: Khalid M Bhatti; Zainab N Al-Balushi; Mahmoud H Sherif; Sareyah M Al-Sibai; Ashfaq A Khan; Mazen A Mohammed; Maria F Batacalan; Cheryl C Montemayor; Mohammad Fazalullah; Masood Ahmed; Mathew Kripail; Asad Ur-Rahman; Zenaida Reyes; Mohamed Abdellatif Journal: Sultan Qaboos Univ Med J Date: 2015-01-21
Authors: Stephen F Kingsmore; Julie A Cakici; Michelle M Clark; Mary Gaughran; Michele Feddock; Sergey Batalov; Matthew N Bainbridge; Jeanne Carroll; Sara A Caylor; Christina Clarke; Yan Ding; Katarzyna Ellsworth; Lauge Farnaes; Amber Hildreth; Charlotte Hobbs; Kiely James; Cyrielle I Kint; Jerica Lenberg; Shareef Nahas; Lance Prince; Iris Reyes; Lisa Salz; Erica Sanford; Peter Schols; Nathaly Sweeney; Mari Tokita; Narayanan Veeraraghavan; Kelly Watkins; Kristen Wigby; Terence Wong; Shimul Chowdhury; Meredith S Wright; David Dimmock Journal: Am J Hum Genet Date: 2019-09-26 Impact factor: 11.025
Authors: Erica F Sanford; Michelle M Clark; Lauge Farnaes; Matthew R Williams; James C Perry; Elizabeth G Ingulli; Nathaly M Sweeney; Ami Doshi; Jeffrey J Gold; Benjamin Briggs; Matthew N Bainbridge; Michele Feddock; Kelly Watkins; Shimul Chowdhury; Shareef A Nahas; David P Dimmock; Stephen F Kingsmore; Nicole G Coufal Journal: Pediatr Crit Care Med Date: 2019-11 Impact factor: 3.624
Authors: Michelle M Clark; Amber Hildreth; Sergey Batalov; Yan Ding; Shimul Chowdhury; Kelly Watkins; Katarzyna Ellsworth; Brandon Camp; Cyrielle I Kint; Calum Yacoubian; Lauge Farnaes; Matthew N Bainbridge; Curtis Beebe; Joshua J A Braun; Margaret Bray; Jeanne Carroll; Julie A Cakici; Sara A Caylor; Christina Clarke; Mitchell P Creed; Jennifer Friedman; Alison Frith; Richard Gain; Mary Gaughran; Shauna George; Sheldon Gilmer; Joseph Gleeson; Jeremy Gore; Haiying Grunenwald; Raymond L Hovey; Marie L Janes; Kejia Lin; Paul D McDonagh; Kyle McBride; Patrick Mulrooney; Shareef Nahas; Daeheon Oh; Albert Oriol; Laura Puckett; Zia Rady; Martin G Reese; Julie Ryu; Lisa Salz; Erica Sanford; Lawrence Stewart; Nathaly Sweeney; Mari Tokita; Luca Van Der Kraan; Sarah White; Kristen Wigby; Brett Williams; Terence Wong; Meredith S Wright; Catherine Yamada; Peter Schols; John Reynders; Kevin Hall; David Dimmock; Narayanan Veeraraghavan; Thomas Defay; Stephen F Kingsmore Journal: Sci Transl Med Date: 2019-04-24 Impact factor: 19.319