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新生儿脑室出血的种族差异减少。

Reduced racial disparities among newborns with intraventricular hemorrhage.

机构信息

Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.

Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Childs Nerv Syst. 2024 Jul;40(7):2051-2059. doi: 10.1007/s00381-024-06369-w. Epub 2024 Mar 25.

Abstract

INTRODUCTION

Intraventricular hemorrhage (IVH) can ensue permanent neurologic dysfunction, morbidity, and mortality. While previous reports have identified disparities based on patient gender or weight, no prior study has assessed how race may influence in neonatal or infantile IVH patients. The aim of this study was to investigate the impact of race on adverse event (AE) rates, length of stay (LOS), and total cost of admission among newborns with IVH.

METHODS

Using the 2016-2019 National Inpatient Sample database, newborns diagnosed with IVH were identified using ICD-10-CM codes. Patients were stratified based on race. Patient characteristics and inpatient outcomes were assessed. Multivariate logistic regression analyses were used to identify the impact of race on extended LOS and exorbitant cost.

RESULTS

Of 1435 patients, 650 were White (45.3%), 270 African American (AA) (18.8%), 300 Hispanic (20.9%), and 215 Other (15.0%). A higher percentage of AA and Other patients than Hispanic and White patients were < 28 days old (p = 0.008). Each of the cohorts had largely similar presenting comorbidities and symptoms, although AA patients did have significantly higher rates of NEC (p < 0.001). There were no observed differences in rates of AEs, rates of mortality, mean LOS, or mean total cost of admission. Similarly, on multivariate analysis, no race was identified as a significant independent predictor of extended LOS or exorbitant cost.

CONCLUSIONS

Our study found that in newborns with IVH, race is not associated with proxies of poor healthcare outcomes like prolonged LOS or excessive cost. Further studies are needed to validate these findings.

摘要

介绍

脑室内出血 (IVH) 可导致永久性神经功能障碍、发病率和死亡率。虽然之前的报告已经确定了基于患者性别或体重的差异,但没有先前的研究评估种族如何影响新生儿或婴儿 IVH 患者。本研究旨在调查种族对 IVH 新生儿不良事件 (AE) 发生率、住院时间 (LOS) 和住院总费用的影响。

方法

使用 2016-2019 年全国住院患者样本数据库,使用 ICD-10-CM 代码识别诊断为 IVH 的新生儿。根据种族对患者进行分层。评估患者特征和住院结果。使用多变量逻辑回归分析确定种族对延长 LOS 和过高费用的影响。

结果

在 1435 名患者中,650 名是白人 (45.3%),270 名非裔美国人 (AA) (18.8%),300 名西班牙裔 (20.9%),215 名其他 (15.0%)。AA 和其他患者中,比西班牙裔和白人患者中 < 28 天的比例更高 (p = 0.008)。每个队列的主要合并症和症状相似,但 AA 患者的 NEC 发生率明显更高 (p < 0.001)。AE 发生率、死亡率、平均 LOS 或平均住院总费用均无差异。同样,在多变量分析中,没有一种种族被确定为延长 LOS 或过高费用的显著独立预测因子。

结论

我们的研究发现,在 IVH 新生儿中,种族与延长 LOS 或过高费用等不良医疗结果的指标无关。需要进一步的研究来验证这些发现。

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