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

Journal of Perinatology volume 34, pages 582–586 (2014)Cite this article

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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.

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Acknowledgements

The CHNC (http://www.thechnc.org) partnered with Children’s Hospital Association, Inc. (Washington, DC and Overland Park, KS) in order to design, launch and maintain the CHND. Inquiries and information can be obtained from Kate Conrad, Vice President (chnd@childrenshospitals.org)

We are indebted to the following institutions that serve the infants and their families, and these institutions also have invested in and continue to participate in the Children’s Hospitals Neonatal Database (CHND). Site sponsors during the study period are indicated in brackets:

1. Children's Healthcare of Atlanta, Atlanta, GA (Francine Dykes, Anthony Piazza)

2. Children’s Healthcare of Atlanta at Scottish Rite (Gregory Sysyn)

3. Children's Hospital of Alabama, Birmingham, AL (Carl Coghill)

4. Le Bonheur Children's Hospital, Memphis, TN (Ramasubbareddy Dhanireddy)

5. Children's Hospital Boston, Boston, MA (Anne Hansen)

6. Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL (Karna Murthy)

7. Nationwide Children's Hospital, Columbus, OH (Kristina Reber)

8. Children's Medical Center, Dallas, TX (Rashmin Savani, Luc Brion)

9. Children's Hospital Colorado, Aurora, CO (Theresa Grover)

10. Children’s Hospital of Michigan, Detroit, MI (Girija Natarajan)

11. Cook Children's Health Care System, Fort Worth, TX (Jonathan Nedrelow, Annie Chi)

12. Texas Children's Hospital, Houston, TX (Yvette Johnson)

13. Children's Mercy Hospitals & Clinics, Kansas City, MO (Eugenia Pallotto)

14. Arkansas Children's Hospital, Little Rock, AR (Becky Rodgers)

15. Children’s Hospital Los Angeles, Los Angeles, CA (Lisa Kelly*, Steven Chin)

16. Children's Hospital & Research Center Oakland, Oakland, CA (David Durand, Jeanette Asselin)

17. The Children's Hospital of Philadelphia, Philadelphia, PA (Jacquelyn Evans, Michael Padula)

18. Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA (Beverly Brozanski)

19. St. Louis Children's Hospital, St Louis, MO (Joan Rosenbaum, Tasmin Najaf)

20. All Children's Hospital, St. Petersburg, FL (Victor McKay)

21. Rady Children's Hospital, San Diego, CA (Mark Speziale)

22. Children's National Medical Center, Washington, DC (Billie Short)

23. AI DuPont Hospital for Children, Wilmington, DE (Kevin Sullivan)

24. Primary Children’s Medical Center, Salt Lake City, UT (Donald Null)

25. Children’s Hospital of Wisconsin, Milwaukee, WI (Michael Uhing)

26. Children’s Hospital of Omaha (Lynne Willett, John Grebe)

27. Florida Hospital for Children (Rajan Wadhawan)

*deceased

Author information

Authors and Affiliations

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

    K Murthy

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

    F D Dykes

  3. Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    M A Padula & J R Evans

  4. Children’s Mercy Hospital and Clinics and the Department of Pediatrics, University of Missouri School of Medicine, Kansas City, MO, USA

    E K Pallotto

  5. Nationwide Children’s Hospital and the Department of Pediatrics, Ohio State University School of Medicine, Columbus, OH, USA

    K M Reber

  6. Department of Pediatrics, Children’s Hospital Oakland & Research Center, Oakland, CA, USA

    D J Durand & J M Asselin

  7. Children’s National Medical Center and the Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA

    B L Short

  8. Children’s Hospital Association,, Overland Park, KS, USA

    I Zaniletti

Authors
  1. K Murthy
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  2. F D Dykes
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  3. M A Padula
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  4. E K Pallotto
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  5. K M Reber
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  6. D J Durand
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  7. B L Short
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  8. J M Asselin
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  9. I Zaniletti
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  10. J R Evans
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Corresponding author

Correspondence to J R Evans.

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Competing interests

JMA received a portion of salary support from CHA in 2011–2013 for the development and maintenance of the database that was analyzed for this study; JRE received a stipend from CHA in 2012; KM received a portion of salary support from CHA in 2012. The remaining authors declare no conflict of interest.

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Disclaimer

Individual disclosures are listed below. CHA had no input in the design of the project, the aims or the decision whether to submit this manuscript for publication. Staff from CHA (IZ and Cary Thurm) led the statistical analyses presented in this report.

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Murthy, K., Dykes, F., Padula, M. et al. The Children’s Hospitals Neonatal Database: an overview of patient complexity, outcomes and variation in care. J Perinatol 34, 582–586 (2014). https://doi.org/10.1038/jp.2014.26

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