Neonatal Intensive Care Unit-Level Patent Ductus Arteriosus Treatment Rates and Outcomes in Infants Born Extremely Preterm Academic Article uri icon

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abstract

  • OBJECTIVES: To assess associations between neonatal intensive care unit (NICU)-level patent ductus arteriosus (PDA) treatment rates (pharmacologic or surgical) and neonatal outcomes. STUDY DESIGN: This cohort study included infants born at 24-28 weeks of gestation and birth weight <1500 g in 2007-2015 in NICUs caring for ≥100 eligible infants in 6 countries. The ratio of observed/expected (O/E) PDA treatment rates was derived for each NICU by estimating the expected rate using a logistic regression model adjusted for potential confounders and network. The primary composite outcome was death or severe neurologic injury (grades III-IV intraventricular hemorrhage or periventricular leukomalacia). The associations between the NICU-level O/E PDA treatment ratio and neonatal outcomes were assessed using linear regression analyses including a quadratic effect (a square term) of the O/E PDA treatment ratio. RESULTS: From 139 NICUs, 39 096 infants were included. The overall PDA treatment rate was 45% in the cohort (13%-77% by NICU) and the O/E PDA treatment ratio ranged from 0.30 to 2.14. The relationship between the O/E PDA treatment ratio and primary composite outcome was U-shaped, with the nadir at a ratio of 1.13 and a significant quadratic effect (P<.001). U-shaped relationships were also identified with death, severe neurologic injury, and necrotizing enterocolitis. CONCLUSIONS: Both low and high PDA treatment rates were associated with death or severe neurologic injury, whereas a moderate approach was associated with optimal outcomes.

authors

  • Isayama, Tetsuya
  • Kusuda, Satoshi
  • Reichman, Brian
  • Lee, Shoo K
  • Lehtonen, Liisa
  • Norman, Mikael
  • Adams, Mark
  • Bassler, Dirk
  • Helenius, Kjell
  • Hakansson, Stellan
  • Yang, Junmin
  • Jain, Amish
  • Shah, Prakesh S
  • Harrison, Adele
  • Synnes, Anne
  • Ting, Joseph
  • Cieslak, Zenon
  • Sherlock, Rebecca
  • Yee, Wendy
  • Aziz, Khalid
  • Toye, Jennifer
  • Fajardo, Carlos
  • Kalapesi, Zarin
  • Sankaran, Koravangattu
  • Daspal, Sibasis
  • Seshia, Mary
  • Alvaro, Ruben
  • Mukerji, Amit
  • Da Silva, Orlando
  • Nwaesei, Chuks
  • Lee, Kyong-Soon
  • Dunn, Michael
  • Lemyre, Brigitte
  • Dow, Kimberly
  • Pelausa, Ermelinda
  • Barrington, Keith
  • Drolet, Christine
  • Piedboeuf, Bruno
  • Claveau, Martine
  • Beltempo, Marc
  • Bertelle, Valerie
  • Masse, Edith
  • Canning, Roderick
  • Makary, Hala
  • Ojah, Cecil
  • Monterrosa, Luis
  • Deshpandey, Akhil
  • Afifi, Jehier
  • Kajetanowicz, Andrzej
  • Andersson, Sture
  • Tammela, Outi
  • Sankilampi, Ulla
  • Saarela, Timo
  • Heymann, Eli
  • Zangen, Shmuel
  • Smolkin, Tatyana
  • Mimouni, Francis
  • Bader, David
  • Rothschild, Avi
  • Strauss, Zipora
  • Felszer, Clari
  • Omari, Hussam
  • Tov-Friedman, Smadar Even
  • Bar-Oz, Benjamin
  • Feldman, Michael
  • Saad, Nizar
  • Flidel-Rimon, Orna
  • Weisbrod, Meir
  • Lubin, Daniel
  • Litmanovitz, Ita
  • Kugelman, Amir
  • Shinwell, Eric
  • Klinger, Gil
  • Nijim, Yousif
  • Bin-Nun, Alona
  • Golan, Agneta
  • Mandel, Dror
  • Fleisher-Sheffer, Vered
  • Kohelet, David
  • Bakhrakh, Lev
  • Hattori, Satoshi
  • Shirai, Masaru
  • Ishioka, Toru
  • Mori, Toshihiko
  • Amizuka, Takasuke
  • Huchimukai, Toru
  • Yoshida, Hiroshi
  • Sasaki, Ayako
  • Shimizu, Junichi
  • Nakamura, Toshihiko
  • Maruyama, Mami
  • Matsumoto, Hiroshi
  • Hosokawa, Shinichi
  • Taki, Atsuko
  • Nakagawa, Machiko
  • Ko, Kyone
  • Uozumi, Azusa
  • Nakata, Setsuko
  • Shimazaki, Akira
  • Yoda, Tatsuya
  • Numata, Osamu
  • Imamura, Hiroaki
  • Kobayashi, Azusa
  • Tokuriki, Shuko
  • Uchida, Yasushi
  • Arai, Takahiro
  • Ito, Mitsuhiro
  • Ieda, Kuniko
  • Ono, Toshiyuki
  • Hayashi, Masashi
  • Maki, Kanemasa
  • Yamakawa, Mie-Toru
  • Kawai, Masahiko
  • Fujii, Noriko
  • Shiomi, Kozue
  • Nozaki, Koji
  • Wada, Hiroshi
  • Kim, Taho
  • Tokunaga, Yasuyuki
  • Tokunaga, Yasuyuki
  • Takatera, Akihiro
  • Oshima, Toshio
  • Sumida, Hiroshi
  • Michinomae, Yae
  • Kusumoto, Yoshio
  • Yoshimoto, Seiji
  • Morisawa, Takeshi
  • Ohashi, Tamaki
  • Takahashi, Yukihiro
  • Sugimoto, Moriharu
  • Ono, Noriaki
  • Miyagawa, Shinichiro
  • Saijo, Takahiko
  • Yamagami, Takashi
  • Koyano, Kosuke
  • Kobayashi, Shoko
  • Kanda, Takeshi
  • Sakemi, Yoshihiro
  • Aoki, Mikio
  • Iida, Koichi
  • Goshi, Mitsushi
  • Maruyama, Yuko
  • Kofron, Jiri
  • Brodd, Katarina Strand
  • Odlind, Andreas
  • Alberg, Lars
  • Arwehed, Sofia
  • Hafström, Ola
  • Kasemo, Anna
  • Nederman, Karin
  • Åhman, Lars
  • Ingemarsson, Fredrik
  • Petersson, Henrik
  • Thurn, Pernilla
  • Albinsson, Eva
  • Selander, Bo
  • Abrahamsson, Thomas
  • Heimdahl, Ingela
  • Sveinsdottir, Kristbjorg
  • Wejryd, Erik
  • Hedlund, Anna
  • Söderberg, Maria Katarina
  • Navér, Lars
  • Brune, Thomas
  • Bäckström, Jens
  • Robinson, Johan
  • Farooqi, Aijaz
  • Normann, Erik
  • Fredriksson, Magnus
  • Palm, Anders
  • Rosenqvist, Urban
  • Walde, Bengt
  • Hagman, Cecilia
  • Ohlin, Andreas
  • Florell, Rein
  • Löfvenberg, Agneta Smedsaas
  • Meyer, Philipp
  • Kusche, Rachel
  • Schulzke, Sven
  • Nelle, Mathias
  • Wagner, Bendicht
  • Riedel, Thomas
  • Kaczala, Grégoire
  • Pfister, Riccardo E
  • Tolsa, Jean-François
  • Roth, Matthias
  • Stocker, Martin
  • Laubscher, Bernhard
  • Malzacher, Andreas
  • Micallef, John P
  • Hegi, Lukas
  • Arlettaz, Romaine
  • Bernet, Vera

publication date

  • May 2020

has subject area