Document Detail


Inter-NICU variation in rates and management of thrombocytopenia among very low birth-weight infants.
MedLine Citation:
PMID:  12774140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate variation among neonatal intensive care units (NICUs) in prevalence and management of thrombocytopenia in infants <1500 g. STUDY DESIGN: In total 1283 infants &<1500 g admitted to six NICUs over 21 months were prospectively analyzed. Illness severity was measured by the Score for Neonatal Acute Physiology (SNAP). Platelet counts in the first 12 hours after birth and on day 3 of life were abstracted from the infants' medical records. Thrombocytopenia was determined from the lowest platelet count in each of these time periods. RESULTS: There was variability in rates of thrombocytopenia among NICUs, even after controlling for risk factors (e.g., SNAP, small for gestational (SGA) age and maternal hypertension). One site had a high prevalence of thrombocytopenia, but the lowest percentage of infants with thrombocytopenia who received platelet transfusions. After controlling for SNAP, GA, SGA, Apgar score and incidence of thrombocytopenia, the odds of receiving platelets at this site, relative to the site with the highest transfusion rate, was 0.10 (95% CI 0.02 to 0.43). CONCLUSIONS: This multicenter study finds a 10-fold variation among NICU in the administration of platelets to their thrombocytopenic infants that cannot be explained by presence of thrombocytopenia or illness severity.
Authors:
Doron J Kahn; Douglas K Richardson; Henny H Billett
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  23     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-05-29     Completed Date:  2003-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  312-6     Citation Subset:  IM    
Affiliation:
Division of Hematology, the Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Humans
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal / statistics & numerical data*
Intracranial Hemorrhages / epidemiology*,  etiology,  prevention & control*
Physician's Practice Patterns / statistics & numerical data*
Platelet Transfusion*
Prevalence
Prospective Studies
Severity of Illness Index
Thrombocytopenia / complications,  epidemiology*,  therapy*
Treatment Outcome

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


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