Shah P S, Mirea L, Ng E, Solimano A, Lee S K
1] Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada [2] Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
1] Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada [2] Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
J Perinatol. 2015 Jul;35(7):522-9. doi: 10.1038/jp.2015.4. Epub 2015 Feb 12.
Assess association of NICU size, and occupancy rate and resource utilization at admission with neonatal outcome.
Retrospective cohort study of 9978 infants born at 23-32 weeks gestation and admitted to 23 tertiary-level Canadian NICUs during 2010-2012. Adjusted odds ratios (AOR) were estimated for a composite outcome of mortality/any major morbidity with respect to NICU size, occupancy rate and intensity of resource utilization at admission.
A total of 2889 (29%) infants developed the composite outcome, the odds of which were higher for 16-29, 30-36 and >36-bed NICUs compared with <16-bed NICUs (AOR (95% CI): 1.47 (1.25-1.73); 1.49 (1.25-1.78); 1.55 (1.29-1.87), respectively) and for NICUs with higher resource utilization at admission (AOR: 1.30 (1.08-1.56), Q4 vs Q1) but not different according to NICU occupancy.
Larger NICUs and more intense resource utilization at admission are associated with higher odds of a composite adverse outcome in very preterm infants.
评估新生儿重症监护病房（NICU）规模、入住率以及入院时资源利用情况与新生儿结局之间的关联。
对2010 - 2012年期间在加拿大23家三级医疗机构NICU住院的9978例孕23 - 32周出生的婴儿进行回顾性队列研究。针对NICU规模、入住率和入院时资源利用强度，估算了死亡率/任何严重并发症这一综合结局的校正比值比（AOR）。
共有2889例（29%）婴儿出现了综合结局，16 - 29张床位、30 - 36张床位以及>36张床位的NICU中出现该结局的几率高于床位<16张的NICU（AOR（95%置信区间）分别为：1.47（1.25 - 1.73）；1.49（1.25 - 1.78）；1.55（1.29 - 1.87）），入院时资源利用较高的NICU中出现该结局的几率也更高（AOR：1.30（1.08 - 1.56），四分位数4对比四分位数1），但根据NICU入住情况无差异。
规模较大的NICU以及入院时更高强度的资源利用与极早产儿出现综合不良结局的较高几率相关。
Zotero 插件