Document Detail


Variations in definitions of mortality have little influence on neonatal intensive care unit performance ratings.
MedLine Citation:
PMID:  22854328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To measure the influence of varying mortality time frames on performance rankings among regional neonatal intensive care units (NICUs) in a large state.
STUDY DESIGN: We performed a cross-sectional data analysis of very low birth weight infants receiving care at 24 level 3 NICUs. We tested the effect of 4 definitions of mortality: (1) death between admission and end of birth hospitalization or up to 366 days; (2) death between 12 hours of age and the end of birth hospitalization or up to 366 days; (3) death between admission and 28 days; and (4) death between 12 hours of age and 28 days. NICUs were ranked by quantifying their deviation from risk-adjusted expected mortality and dividing them into 3 tiers: top 6, bottom 6, and in between.
RESULTS: There was wide interinstitutional variation in risk-adjusted mortality for each definition (observed minus expected z-score range, -6.08 to 3.75). However, mortality-based NICU rankings and classification into performance tiers were very similar for all institutions in each of our time frames. Among all 4 definitions, NICU rank correlations were high (>0.91). Few NICUs changed relative to a neighboring tier with changes in definitions, and none changed by more than one tier.
CONCLUSION: The time frame used to ascertain mortality had little effect on comparative NICU performance.
Authors:
Jochen Profit; Jeffrey B Gould; David Draper; John A F Zupancic; Marc A Kowalkowski; LeChauncy Woodard; Kenneth Pietz; Laura A Petersen
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-07-31
Journal Detail:
Title:  The Journal of pediatrics     Volume:  162     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-02-19     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  50-5.e2     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Cross-Sectional Studies
Female
Humans
Infant Mortality*
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal / standards*
Male
Quality of Health Care / standards*
Terminology as Topic
Grant Support
ID/Acronym/Agency:
K23 HD056298/HD/NICHD NIH HHS; K23 HD056298/HD/NICHD NIH HHS
Comments/Corrections

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


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