Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, and Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Department of Pediatrics, Indiana University, Indianapolis, IN, and Division of Neonatology, Riley Hospital for Children, Indianapolis, IN, USA.
J Perinatol. 2021 Dec;41(12):2820-2825. doi: 10.1038/s41372-021-01286-1. Epub 2022 Jan 4.
To characterize infants who underwent autopsy in regional neonatal intensive care units (NICUs) and examine inter-center variability in autopsy completion.
Retrospective cohort study of infants who died between 2010 and 2016 from 32 participating hospitals in the Children's Hospital Neonatal Database (CHND). Maternal/infant demographics and hospital stay data were collected, along with autopsy rates by center, year, and region. Data analysis utilized bivariate and multivariable statistics.
Of 6299 deaths, 1742 (27.7%) completed autopsy. Infants who underwent autopsy had higher median birth weight (2 124 g vs. 1 655 g) and gestational age (34 vs. 32 weeks). No differences were seen in sex, length of stay, or primary cause of death. Marked inter-center variability was observed, with 17-fold adjusted difference (p < 0.001) in autopsy rates.
Patient characteristics do not account for variability in autopsy practices across regional NICUs. Factors such as provider practices and parental preferences should be investigated.
描述在地区新生儿重症监护病房（NICU）进行尸检的婴儿，并检查尸检完成情况的中心间差异。
这是一项回顾性队列研究，纳入了 2010 年至 2016 年期间来自儿童医院新生儿数据库（CHND）32 家参与医院死亡的婴儿。收集了母婴/婴儿人口统计学和住院数据，以及按中心、年份和地区划分的尸检率。数据分析采用了双变量和多变量统计。
在 6299 例死亡中，有 1742 例（27.7%）完成了尸检。接受尸检的婴儿的中位出生体重（2124g 比 1655g）和胎龄（34 周比 32 周）更高。性别、住院时间和主要死因方面无差异。观察到明显的中心间差异，尸检率的调整后差异达 17 倍（p<0.001）。
患者特征不能解释地区 NICU 之间尸检实践的差异。应调查提供者实践和家长偏好等因素。
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