Ankur Datta1, Jason Z Niehaus2, Julie Weiner3, Isabella Zaniletti4, Nana Matoba5, Kevin M Sullivan6, Robert DiGeronimo7, Carl H Coghill8, Girija Natarajan9, Steven R Leuthner10, Amy Brown Schlegel11, Anita Shah12, Karna Murthy5, Jessica T Fry5. 1. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, and Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. adatta@luriechildrens.org. 2. Department of Pediatrics, Indiana University, Indianapolis, IN, and Division of Neonatology, Riley Hospital for Children, Indianapolis, IN, USA. 3. Department of Pediatrics, University of Missouri - Kansas City, Detroit, MI, and Division of Neonatology, Children's Mercy Hospital, Kansas City, MO, USA. 4. Children's Hospitals Association, Overland Park, KS, USA. 5. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, and Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. 6. Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, and Division of Neonatology, Nemours/AI duPont Hospital for Children, Wilmington, DE, USA. 7. Department of Pediatrics, University of Washington, Seattle, WA, and Division of Neonatology, Seattle Children's Hospital, Seattle, WA, USA. 8. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, and Division of Neonatology, Children's of Alabama, Birmingham, AL, USA. 9. Department of Pediatrics, Wayne State University, Detroit, MI, and Division of Neonatology, Children's Hospital of Michigan, Detroit, MI, USA. 10. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, and Division of Neonatology, Children's Hospital of Wisconsin, Milwaukee, WI, USA. 11. Department of Pediatrics, The Ohio State College of Medicine, Columbus, OH, and Division of Neonatology, Nationwide Children's Hospital, Columbus, OH, USA. 12. Department of Pediatrics, University of California at Irvine, Irvine, CA, and Division of Neonatology, Children's Hospital of Orange County, Orange, CA, USA.
Abstract
OBJECTIVE: To characterize infants who underwent autopsy in regional neonatal intensive care units (NICUs) and examine inter-center variability in autopsy completion. STUDY DESIGN: Retrospective cohort study of infants who died between 2010 and 2016 from 32 participating hospitals in the Children's Hospital Neonatal Database (CHND). Maternal/infant demographics and hospital stay data were collected, along with autopsy rates by center, year, and region. Data analysis utilized bivariate and multivariable statistics. RESULT: Of 6299 deaths, 1742 (27.7%) completed autopsy. Infants who underwent autopsy had higher median birth weight (2 124 g vs. 1 655 g) and gestational age (34 vs. 32 weeks). No differences were seen in sex, length of stay, or primary cause of death. Marked inter-center variability was observed, with 17-fold adjusted difference (p < 0.001) in autopsy rates. CONCLUSION: Patient characteristics do not account for variability in autopsy practices across regional NICUs. Factors such as provider practices and parental preferences should be investigated.
OBJECTIVE: To characterize infants who underwent autopsy in regional neonatal intensive care units (NICUs) and examine inter-center variability in autopsy completion. STUDY DESIGN: Retrospective cohort study of infants who died between 2010 and 2016 from 32 participating hospitals in the Children's Hospital Neonatal Database (CHND). Maternal/infant demographics and hospital stay data were collected, along with autopsy rates by center, year, and region. Data analysis utilized bivariate and multivariable statistics. RESULT: Of 6299 deaths, 1742 (27.7%) completed autopsy. Infants who underwent autopsy had higher median birth weight (2 124 g vs. 1 655 g) and gestational age (34 vs. 32 weeks). No differences were seen in sex, length of stay, or primary cause of death. Marked inter-center variability was observed, with 17-fold adjusted difference (p < 0.001) in autopsy rates. CONCLUSION: Patient characteristics do not account for variability in autopsy practices across regional NICUs. Factors such as provider practices and parental preferences should be investigated.