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Neonatal Intensive ...
Neonatal Intensive Care Unit-Level Patent Ductus Arteriosus Treatment Rates and Outcomes in Infants Born Extremely Preterm
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Isayama, Tetsuya (author)
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Kusuda, Satoshi (author)
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Reichman, Brian (author)
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Lee, Shoo K. (author)
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Lehtonen, Liisa (author)
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- Norman, Mikael (author)
- Karolinska Institutet
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Adams, Mark (author)
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Bassler, Dirk (author)
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Helenius, Kjell (author)
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- Håkansson, Stellan (author)
- Umeå universitet,Pediatrik
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Yang, Junmin (author)
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Jain, Amish (author)
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Shah, Prakesh S. (author)
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(creator_code:org_t)
- Elsevier, 2020
- 2020
- English.
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In: Journal of Pediatrics. - : Elsevier. - 0022-3476 .- 1097-6833. ; 220, s. 34-39.e05
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Isayama, Tetsuya
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Kusuda, Satoshi
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Reichman, Brian
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Lee, Shoo K.
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Lehtonen, Liisa
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Norman, Mikael
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show more...
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Adams, Mark
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Bassler, Dirk
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Helenius, Kjell
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Håkansson, Stell ...
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Yang, Junmin
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Jain, Amish
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Shah, Prakesh S.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
- Articles in the publication
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Journal of Pedia ...
- By the university
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Umeå University
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Karolinska Institutet