Variability in 28-day outcomes for very low birth weight infants: an analysis of 11 neonatal intensive care units.
A retrospective study of all infants weighing 701 to 1,500 g born at 11 neonatal intensive care centers during 1983 and 1984 was performed to determine whether two specific 28-day outcomes, survival and survival without the need for supplemental oxygen, varied among the centers. Survival without the need for supplemental oxygen was chosen as a reflection of infants surviving without chronic lung disease. There were 1,776 live-born infants delivered during the 2-year study period. Of these infants, 85% (1,512) survived 28 days, a range of 80% to 92% at the individual centers. A total of 60% (1,056) of the infants were alive without supplemental oxygen on day 28, a range of 51% to 70% at the individual centers. Multivariate analysis demonstrated that both survival on day 28 (chi 2 = 23.9, P less than .01) and survival without supplemental oxygen on day 28 (chi 2 = 44.2, P less than .0001) varied significantly among centers after the effects of birth weight, gender, and race were taken into account. Female gender, nonwhite race, and increased birth weight were factors associated with improved rates of survival and survival without supplemental oxygen. The magnitude of outcome variation among centers was estimated by using the logistic regression models to predict what the outcomes would be if each center were to treat a standardized population consisting of all 1,776 study infants.(ABSTRACT TRUNCATED AT 250 WORDS)
Horbar
J D
JD
Department of Pediatrics, University of Vermont, Burlington.
McAuliffe
T L
TL
Adler
S M
SM
Albersheim
S
S
Cassady
G
G
Edwards
W
W
Jones
R
R
Kattwinkel
J
J
Kraybill
E N
EN
Krishnan
V
V
D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D002170:Canada; D004739:England; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality* / Q000628:therapy; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D008297:Male; D010100:Oxygen / Q000627:therapeutic use; D012121:Respiration, Artificial; D012737:Sex Factors; D014481:United States; D044465:White People
D010100:Oxygen