Document Detail


Clinical predictors and institutional variation in home oxygen use in preterm infants.
MedLine Citation:
PMID:  21962601     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess home oxygen use in preterm infants, identify risk factors predicting home oxygen use, and quantify the extent of institutional variation in home oxygen use across neonatal intensive care units.
STUDY DESIGN: We conducted a retrospective cohort analysis of surviving infants of 23- to 31-week gestational age discharged home in 2009, with de-identified electronic medical record information from the Pediatrix Clinical Data Warehouse. Mixed-effects logistic regression quantified clinical risk factors and institutional variation affecting home oxygen use.
RESULTS: A total of 8167 infants were identified. Home oxygen use varied by gestational age, from 59% of infants 23 to 24 weeks gestational age to 7% of infants 29 to 31 weeks gestational age. Other risk factors included small for gestational age, congenital anomalies, mechanical ventilation in the first 72 hours, fraction of inhaled oxygen >0.4 in the first 72 hours, and patent ductus arteriosus. After adjusting for clinical risk factors, there was still a 4- to 5-fold difference in institutions' odds of home oxygen use.
CONCLUSIONS: Home oxygen use was common in infants of earlier gestational ages and infants with more severe respiratory illness. Institutional variation accounted for 4- to 5-fold variation in home oxygen use. Families should be counseled about the likelihood of home oxygen use, and prospective research must identify optimal treatment strategies for high-risk infants.
Authors:
Joanne Lagatta; Reese Clark; Alan Spitzer
Publication Detail:
Type:  Journal Article     Date:  2011-09-29
Journal Detail:
Title:  The Journal of pediatrics     Volume:  160     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-13     Completed Date:  2012-02-28     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  232-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Affiliation:
Medical College of Wisconsin, Milwaukee, WI 53204, USA. jlagatta@mcw.edu
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MeSH Terms
Descriptor/Qualifier:
Female
Gestational Age*
Home Care Services / utilization*
Humans
Infant, Newborn
Infant, Premature* / growth & development
Male
Medical Records / statistics & numerical data
Oxygen Inhalation Therapy / methods*
Pregnancy
Retrospective Studies
Risk Factors
Grant Support
ID/Acronym/Agency:
UL1 TR000055/TR/NCATS NIH HHS
Comments/Corrections
Comment In:
J Pediatr. 2012 Feb;160(2):187-8   [PMID:  22048055 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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