儿童医院新生儿联盟胃裂患儿住院结果的中心间差异

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-12-11 DOI:10.1038/s41372-024-02160-6

Con Yee Ling, Isabella Zaniletti, Stefanie Riddle, Jacobson Elizabeth, Stephanie G Korff, Angela L Chandler, L Corbin Downey, Michael A Padula, Jacquelyn R Evans, Theresa R Grover, Karna Murthy

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引用次数: 0

摘要

目的：探讨胃裂患儿住院时间（LOS）和出院时口服喂养的中心间差异（ICV）。研究设计：使用儿童医院新生儿联盟（CHNC）数据库来识别胃裂住院幸存者。评估两项结果：LOS和无管喂养的排泄。在未调整和调整分析中评估医院结果。采用gamma分布的带对数链的广义线性模型对无管道进料排放的LOS和逻辑回归进行建模。结果：3987例存活的胃裂患儿，单纯口服喂养70 d内的LOS和出院均表现出显著的ICV。在多变量分析中，差异依然存在。风险调整后的LOS（差异68%）和出院时的口服喂养（差异6.4倍）在各中心之间差异显著。结论：护理医院与胃裂患儿的LOS和单纯口服喂养的出院率独立相关。管理上的差异，可能受到父母偏好的影响，导致了变异。

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Inter-center variations in inpatient outcomes for infants with gastroschisis from the Children's Hospitals Neonatal Consortium.

Objective: To estimate inter-center variation (ICV) in hospital length of stay (LOS) and oral feeding at discharge among infants with gastroschisis.

Study design: The Children's Hospitals Neonatal Consortium's (CHNC) database was used to identify hospitalized survivors with gastroschisis. Two outcomes were evaluated: LOS and discharge without tube feedings. Hospital outcomes were evaluated in unadjusted and adjusted analyses. Generalized linear models with log link for gamma distribution were used to model LOS and logistic regression for discharge without tube feeds.

Results: For 3987 surviving infants with gastroschisis, LOS and discharge within 70 days with exclusively oral feeding both exhibited significant ICV. Differences persisted in multivariable analyses. Risk-adjusted LOS (68% difference) and oral feeding at discharge (6.4-fold difference) varied significantly between centers.

Conclusion: Hospital of care was independently associated with LOS and exclusive oral feeding at discharge rates for infants with gastroschisis. Management differences, potentially influenced by parental preferences, contributed to variation.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.