The impact of volume and neonatal level of care on outcomes of moderate and late preterm infants
© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc..
OBJECTIVE: Evaluate the relationship of neonatal unit level of care (LOC) and volume with mortality or morbidity in moderate-late preterm (MLP) (32-36 weeks' gestation) infants.
DESIGN: Retrospective cohort study of 650,865 inborn MLP infants in 4976 hospitals-years using 2003-2015 linked administrative data from 4 states. Exposure was combined neonatal LOC and MLP annual volume. The primary outcome was death or morbidity (respiratory distress syndrome, severe intraventricular hemorrhage, necrotizing enterocolitis, sepsis, infection, pneumothorax, extreme length of stay) with components as secondary outcomes. Poisson regression models adjusted for patient characteristics with a random effect for unit were used.
RESULTS: In adjusted models, high-volume level 2 units had a lower risk of the primary outcome compared to low-volume level 3 units (aIRR 0.90 [95% CI 0.83-0.98] vs. aIRR 1.13 [95% CI 1.03-1.24], p < 0.001) CONCLUSION: MLP infants had improved outcomes in high-volume level 2 units compared to low-volume level 3 units in adjusted analysis.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Journal of perinatology : official journal of the California Perinatal Association - (2024) vom: 27. Feb. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Salazar, Elizabeth G [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 27.02.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1038/s41372-024-01901-x |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369036883 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369036883 | ||
| 003 | DE-627 | ||
| 005 | 20240229171541.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240229s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1038/s41372-024-01901-x |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1310.xml |
| 035 | |a (DE-627)NLM369036883 | ||
| 035 | |a (NLM)38413758 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Salazar, Elizabeth G |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of volume and neonatal level of care on outcomes of moderate and late preterm infants |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 27.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer Nature America, Inc. | ||
| 520 | |a OBJECTIVE: Evaluate the relationship of neonatal unit level of care (LOC) and volume with mortality or morbidity in moderate-late preterm (MLP) (32-36 weeks' gestation) infants | ||
| 520 | |a DESIGN: Retrospective cohort study of 650,865 inborn MLP infants in 4976 hospitals-years using 2003-2015 linked administrative data from 4 states. Exposure was combined neonatal LOC and MLP annual volume. The primary outcome was death or morbidity (respiratory distress syndrome, severe intraventricular hemorrhage, necrotizing enterocolitis, sepsis, infection, pneumothorax, extreme length of stay) with components as secondary outcomes. Poisson regression models adjusted for patient characteristics with a random effect for unit were used | ||
| 520 | |a RESULTS: In adjusted models, high-volume level 2 units had a lower risk of the primary outcome compared to low-volume level 3 units (aIRR 0.90 [95% CI 0.83-0.98] vs. aIRR 1.13 [95% CI 1.03-1.24], p < 0.001) CONCLUSION: MLP infants had improved outcomes in high-volume level 2 units compared to low-volume level 3 units in adjusted analysis | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Passarella, Molly |e verfasserin |4 aut | |
| 700 | 1 | |a Formanowski, Brielle |e verfasserin |4 aut | |
| 700 | 1 | |a Phibbs, Ciaran S |e verfasserin |4 aut | |
| 700 | 1 | |a Lorch, Scott A |e verfasserin |4 aut | |
| 700 | 1 | |a Handley, Sara C |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of perinatology : official journal of the California Perinatal Association |d 1993 |g (2024) vom: 27. Feb. |w (DE-627)NLM01262943X |x 1476-5543 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:27 |g month:02 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1038/s41372-024-01901-x |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 27 |c 02 | ||