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Outcomes of neonatal patent ductus arteriosus ligation in Canadian neonatal units with and without pediatric cardiac surgery programs.

https://arctichealth.org/en/permalink/ahliterature113672
Source
J Pediatr Surg. 2013 May;48(5):909-14
Publication Type
Article
Date
May-2013
Author
Charles Wong
Michael Mak
Sandesh Shivananda
Junmin Yang
Prakeshkumar S Shah
Wendy Seidlitz
Julia Pemberton
Peter G Fitzgerald
Brian H Cameron
Author Affiliation
McMaster Pediatric Surgery Research Collaborative, Hamilton ON, Canada.
Source
J Pediatr Surg. 2013 May;48(5):909-14
Date
May-2013
Language
English
Publication Type
Article
Keywords
Abnormalities, Multiple - epidemiology
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Brain Diseases - epidemiology - etiology - ultrasonography
Canada
Cardiology Service, Hospital - organization & administration
Combined Modality Therapy
Databases, Factual
Ductus Arteriosus, Patent - drug therapy - mortality - surgery
Female
Hospital Departments - organization & administration
Hospital Mortality
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - mortality - surgery
Infant, Small for Gestational Age
Intensive Care Units, Neonatal - statistics & numerical data
Ligation
Male
Patient Transfer - statistics & numerical data
Pediatrics - organization & administration
Postoperative Complications - epidemiology - etiology - ultrasonography
Retrospective Studies
Sepsis - epidemiology - etiology
Severity of Illness Index
Surgery Department, Hospital - organization & administration
Tertiary Care Centers - organization & administration - statistics & numerical data
Treatment Outcome
Abstract
Preterm infants needing patent ductus arteriosus (PDA) ligation are transferred to a pediatric cardiac center (CC) unless the operation can be done locally by a pediatric surgeon at a non-cardiac center (NCC). We compared infant outcomes after PDA ligation at CC and NCC.
We analyzed 990 preterm infants who had PDA ligation between 2005 and 2009 using the Canadian Neonatal Network database. In-hospital mortality and major morbidities were compared between CC (n=18) and NCC (n=9).
SNAP-II-adjusted mortality rates were similar (CC=8.7% vs NCC=10.7%, P=.32). Significant cranial ultrasound abnormalities (CC=24.1% vs NCC=32.1%, P
PubMed ID
23701758 View in PubMed
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Prediction of neonatal outcomes in extremely preterm neonates.

https://arctichealth.org/en/permalink/ahliterature107072
Source
Pediatrics. 2013 Oct;132(4):e876-85
Publication Type
Article
Date
Oct-2013
Author
Wen J Ge
Lucia Mirea
Junmin Yang
Kate L Bassil
Shoo K Lee
Prakeshkumar S Shah
Author Affiliation
Maternal-Infant Care (MiCare) Research Centre, Mount Sinai Hospital, 700 University Ave, Suite 8-500, Toronto, Ontario M5G 1X6. lmirea@mtsinai.on.ca.
Source
Pediatrics. 2013 Oct;132(4):e876-85
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cohort Studies
Databases, Factual - trends
Humans
Infant, Extremely Premature - physiology
Infant, Newborn
Infant, Premature, Diseases - diagnosis - mortality - therapy
Intensive Care Units, Neonatal - trends
Population Surveillance - methods
Predictive value of tests
Risk factors
Survival Rate - trends
Treatment Outcome
Abstract
To develop and validate a statistical prediction model spanning the severity range of neonatal outcomes in infants born at = 30 weeks' gestation.
A national cohort of infants, born at 23 to 30 weeks' gestation and admitted to level III NICUs in Canada in 2010-2011, was identified from the Canadian Neonatal Network database. A multinomial logistic regression model was developed to predict survival without morbidities, mild morbidities, severe morbidities, or mortality, using maternal, obstetric, and infant characteristics available within the first day of NICU admission. Discrimination and calibration were assessed using a concordance C-statistic and the Cg goodness-of-fit test, respectively. Internal validation was performed using a bootstrap approach.
Of 6106 eligible infants, 2280 (37%) survived without morbidities, 1964 (32%) and 1251 (21%) survived with mild and severe morbidities, respectively, and 611 (10%) died. Predictors in the model were gestational age, small (20, outborn status, use of antenatal corticosteroids, and receipt of surfactant and mechanical ventilation on the first day of admission. High model discrimination was confirmed by internal bootstrap validation (bias-corrected C-statistic = 0.899, 95% confidence interval = 0.894-0.903). Predicted probabilities were consistent with the observed outcomes (Cg P value = .96).
Neonatal outcomes ranging from mortality to survival without morbidity in extremely preterm infants can be predicted on their first day in the NICU by using a multinomial model with good discrimination and calibration. The prediction model requires additional external validation.
PubMed ID
24062365 View in PubMed
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