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儿童医院新生儿数据库:患者复杂性、治疗结果及护理差异概述

The Children's Hospitals Neonatal Database: an overview of patient complexity, outcomes and variation in care.

作者信息

Murthy K, Dykes F D, Padula M A, Pallotto E K, Reber K M, Durand D J, Short B L, Asselin J M, Zaniletti I, Evans J R

机构信息

Ann & Robert H Lurie Children's Hospital of Chicago, Department of Pediatrics, Feinberg School of Medicine, Northwestern University Chicago, Chicago, IL, USA.

Children's Healthcare of Atlanta at Egleston and the Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.

出版信息

J Perinatol. 2014 Aug;34(8):582-6. doi: 10.1038/jp.2014.26. Epub 2014 Mar 6.

Abstract

The Children's Hospitals Neonatal Consortium is a multicenter collaboration of leaders from 27 regional neonatal intensive care units (NICUs) who partnered with the Children's Hospital Association to develop the Children's Hospitals Neonatal Database (CHND), launched in 2010. The purpose of this report is to provide a first summary of the population of infants cared for in these NICUs, including representative diagnoses and short-term outcomes, as well as to characterize the participating NICUs and institutions. During the first 2 1/2 years of data collection, 40910 infants were eligible. Few were born inside these hospitals (2.8%) and the median gestational age at birth was 36 weeks. Surgical intervention (32%) was common; however, mortality (5.6%) was infrequent. Initial queries into diagnosis-specific inter-center variation in care practices and short-term outcomes, including length of stay, showed striking differences. The CHND provides a contemporary, national benchmark of short-term outcomes for infants with uncommon neonatal illnesses. These data will be valuable in counseling families and for conducting observational studies, clinical trials and collaborative quality improvement initiatives.

摘要

儿童医院新生儿联盟是一个由来自27个地区新生儿重症监护病房(NICU)的负责人组成的多中心合作组织,他们与儿童医院协会合作开发了2010年推出的儿童医院新生儿数据库(CHND)。本报告的目的是首次总结这些新生儿重症监护病房中接受护理的婴儿群体情况,包括代表性诊断和短期结局,同时描述参与的新生儿重症监护病房和机构的特征。在数据收集的前两年半时间里,有40910名婴儿符合条件。很少有婴儿在这些医院内出生(2.8%),出生时的中位孕周为36周。手术干预(32%)很常见;然而,死亡率(5.6%)并不高。对护理实践和短期结局(包括住院时间)中特定诊断的中心间差异进行的初步查询显示出显著差异。CHND为患有罕见新生儿疾病的婴儿提供了一个当代的全国短期结局基准。这些数据在为家庭提供咨询以及进行观察性研究、临床试验和合作质量改进计划方面将很有价值。

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