Document Detail


Population-based estimates of in-unit survival for very preterm infants.
MedLine Citation:
PMID:  23319523     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Estimates of the probability of survival of very preterm infants admitted to NICU care are vital for counseling parents, informing care, and planning services. In 1999, easy-to-use charts of survival according to gestation, birth weight, and gender were published in the United Kingdom. These charts are widely used in clinical care and for benchmarking survival, and they form the core of the Clinical Risk Index for Babies II score. Since their publication, the survival of preterm infants has improved, and the charts therefore need updating.
METHODS: A logistic model was fitted with gestational age, birth weight, and gender. Nonlinear functions were estimated by using fractional polynomials. Bootstrap methods were used to assess the internal validity of the final model. The final model was assessed both overall and for subgroups of infants by using Farrington's statistic, the c-statistic, Cox regression coefficients, and the Brier score.
RESULTS: A total of 2995 white singleton infants born at 23(+0) to 32(+6) weeks' gestation in 2008 through 2010 were identified; 2751 (91.9%) infants survived to discharge. A prediction model was estimated and good model fit confirmed (area under receiver-operating characteristics curve = 0.86). Survival ranged from 27.7% (23 weeks) to 99.1% (32 weeks) for boys and from 34.5% (23 weeks) to 99.3% (32 weeks) for girls. Updated charts were produced showing estimated survival according to gestation, birth weight and gender, together with contour plots displaying points of equal survival.
CONCLUSIONS: These survival charts have been updated and will be of use to clinicians, parents, and managers.
Authors:
Bradley N Manktelow; Sarah E Seaton; David J Field; Elizabeth S Draper
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-14
Journal Detail:
Title:  Pediatrics     Volume:  131     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-04     Completed Date:  2013-04-11     Revised Date:  2014-03-14    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e425-32     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
England
Female
Gestational Age*
Hospital Mortality*
Humans
Infant, Extremely Low Birth Weight*
Infant, Newborn
Infant, Premature, Diseases / mortality*
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal / statistics & numerical data*
Male
Medical Audit
Probability
Prognosis
Sex Factors
Survival Analysis
Grant Support
ID/Acronym/Agency:
RP-PG-0407-10029//Department of Health

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


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