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Predicting survival in infants born at <27 weeks gestation admitted to an all referral neonatal intensive care unit: a pilot study

Journal of Perinatology volume 40, pages 750–757 (2020)Cite this article

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Abstract

Background

There are no available predictive models for survival in extremely preterm (EP) infants admitted to a referral Level IV neonatal intensive care unit (NICU) after the first day of life (DOL).

Objective

To determine if there are clinical variables present at admission that are associated with survival in an outborn EP population.

Study design

Data were analyzed from EP infants admitted before DOL 100 from 2008 to 2016 (n = 744).

Results

We found that prophylactic indomethacin (OR 1.98 (1.20–3.25) p = 0.007), admit DOL (OR 1.05 (1.02–1.08) p < 0.001), and birth in Franklin County, (OR 2.02 (95% CI, 1.04–3.90) p = 0.04) were all associated with survival. Using ROC analysis, the area under the curve for the provisional survival score was 0.69 (95% CI, 0.64–0.75; p < 0.0001).

Conclusions

There are factors on admission to a referral Level IV NICU associated with survival in EP patients.

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Fig. 1: Survival in this cohort of EP infants transferred to an all referral Level IV NICU at a free-standing children’s hospital improved from 2008 to 2016.
Fig. 2: The timing of morality within the cohort of EP patients transferred to a Level IV NICU in an all referral Children’s Hospital.
Fig. 3: The distribution of PSS values within the cohort of EP patients transferred to a Level IV NICU in an all referral Children’s Hospital.

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Authors and Affiliations

  1. Center for Perinatal Research, Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Nikou Pishevar, Carl H. Backes & Leif D. Nelin

  2. Small Baby ICU, Nationwide Children’s Hospital, Columbus, OH, USA

    Omid Fathi, Carl H. Backes, Edward G. Shepherd & Leif D. Nelin

  3. Department of Pediatrics, The Ohio State University, Columbus, OH, USA

    Omid Fathi, Carl H. Backes, Edward G. Shepherd & Leif D. Nelin

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  1. Nikou Pishevar
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  2. Omid Fathi
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  5. Leif D. Nelin
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Correspondence to Leif D. Nelin.

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Pishevar, N., Fathi, O., Backes, C.H. et al. Predicting survival in infants born at <27 weeks gestation admitted to an all referral neonatal intensive care unit: a pilot study. J Perinatol 40, 750–757 (2020). https://doi.org/10.1038/s41372-020-0629-x

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