Covariation of changing patent ductus arteriosus management and preterm infant outcomes in Pediatrix neonatal intensive care units.
OBJECTIVE: To test the hypothesis that NICU-specific preterm infant outcomes co-vary with changes in local patent ductus arteriosus (PDA) management. STUDY DESIGN: This retrospective multicenter study examined NICU-specific aggregated data for infants born 400-1499 g (VLBW) in the Pediatrix Clinical Data Warehouse. For each NICU and each year 2006-2016 we calculated proportion of infants receiving cyclooxygenase inhibitor (COXI) and/or PDA ligation and determined NICU-specific changes in these therapies between consecutive years. We examined relationships between NICU-specific changes in COXI/ligation and concurrent changes in local adjusted in-hospital outcomes. RESULTS: In 5678 observations of change at 259 NICUs summarizing 78,105 infants, between-year decreases in NICU-specific proportion treated with COXI/ligation were associated with concurrent increases in local mortality and decreases in BPD among infants 400-749 g, and with decreased pulmonary hemorrhage in larger infants. CONCLUSIONS: NICU-specific adjusted mortality, BPD, and pulmonary hemorrhage rates co-vary with changes in local COXI/ligation rates in some VLBW infant subgroups.
Duke Scholars
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Related Subject Headings
- Retrospective Studies
- Pediatrics
- Ligation
- Intensive Care Units, Neonatal
- Infant, Premature
- Infant, Newborn
- Infant
- Humans
- Ductus Arteriosus, Patent
- Cyclooxygenase Inhibitors
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Retrospective Studies
- Pediatrics
- Ligation
- Intensive Care Units, Neonatal
- Infant, Premature
- Infant, Newborn
- Infant
- Humans
- Ductus Arteriosus, Patent
- Cyclooxygenase Inhibitors