Faculty Collaboration Database

Inter-center variation in death or tracheostomy placement in infants with severe bronchopulmonary dysplasia. J Perinatol 2017 Jun;37(6):723-727

Date

02/10/2017

Pubmed ID

28181997

DOI

10.1038/jp.2016.277

Scopus ID

2-s2.0-85011915265 (requires institutional sign-in at Scopus site)   43 Citations

Abstract

OBJECTIVE: To estimate the presence and sources of inter-center variation (ICV) in the risk of death or tracheostomy placement (D/T) among infants with severe bronchopulmonary dysplasia (sBPD)Study design:We analyzed the Children's Hospitals Neonatal Database between 2010 and 2013 to identify referred infants born <32 weeks' gestation with sBPD. The association between center and the primary outcome of D/T was analyzed by multivariable modeling. Hypothesized diagnoses/practices were included to determine if these explained any observed ICV in D/T.

RESULTS: D/T occurred in 280 (20%) of 1383 eligible infants from 21 centers. ICV was significant for D/T (range 2-46% by center, P<0.001) and tracheostomy placement (n=187, range 2-37%, P<0.001), but not death (n=93, range 0-19%, P=0.08). This association persisted in multivariable analysis (adjusted center-specific odds ratios for D/T varied 5.5-fold, P=0.009).

CONCLUSIONS: ICV in D/T is apparent among infants with sBPD. These results highlight that the indications for tracheostomy (and subsequent chronic ventilation) remain uncertain.

Author List

Murthy K, Porta NFM, Lagatta JM, Zaniletti I, Truog WE, Grover TR, Nelin LD, Savani RC

Author

Joanne M. Lagatta MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bronchopulmonary Dysplasia
Databases, Factual
Female
Gestational Age
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Intensive Care Units, Neonatal
Male
Multivariate Analysis
Severity of Illness Index
Tracheostomy
United States