Mortality and morbidity by month of birth of neonates admitted to an academic neonatal intensive care unit.
BACKGROUND
Clinical expertise and skill of pediatric housestaff improve over the academic year, and performance varies despite supervision by faculty neonatologists. It is possible that variation in clinical expertise of housestaff affects important clinical outcomes in infants in ICUs.


OBJECTIVE
Our goal was to test the hypothesis that there is a decrease in morbidity and mortality in infants admitted to an NICU over the course of the academic year.


METHODS
A retrospective analysis was conducted using data on infants with birthweight 401 to 1500 g and >or=24 weeks' gestation (n = 3445) and infants with birth weights >1500 g (n = 7840) admitted to a regional NICU from January 1991 to June 2004. All infants were cared for by pediatric and neonatal housestaff supervised by neonatologists. Analysis of mortality and morbidity (intraventricular hemorrhage grades 3-4/periventricular leukomalacia, necrotizing enterocolitis >or= Bell stage 2, and bronchopulmonary dysplasia) over time were performed by repeated measures analysis of variance and the chi(2) test.


RESULTS
Mortality rate in the 401 to 1500 g cohort, as well as the >1500 g cohort did not decrease over time during the academic year and was similar between the first (July-December) and second (January-June) halves of the academic year. There were no differences noted over the academic year for any of the morbidities.


CONCLUSIONS
Morbidity and mortality in infants admitted to an academic NICU did not change significantly over the academic year. These observations suggest that the quality of care of critically ill neonates is not decreased early in the academic year.
Soltau
Thomas D
TD
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA.
Carlo
Waldemar A
WA
Gee
Jonathan
J
Gould
Jeffrey
J
Ambalavanan
Namasivayam
N
D000407:Alabama / Q000453:epidemiology; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D002983:Clinical Competence / Q000706:statistics & numerical data*; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D009359:Neonatology / Q000193:education; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies