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Outcomes for Infants Born in Perinatal Centers Performing Fewer Surgical Ligations for Patent Ductus Arteriosus: A Swiss Population-Based Study

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اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • Publisher Information:
      Elsevier 2021-10-01
    • نبذة مختصرة :
      Objective To assess patent ductus arteriosus treatment variation between Swiss perinatal centers and to determine its effect on outcome in a population-based setting. Study design This was a retrospective cohort study of infants born less than 28 weeks of gestation between 2012 and 2017. Outcomes between surgically ligated and pharmacologically treated infants as well as infants born in centers performing ≤10% ligation (“low” group) and >10% (“high” group) were compared using logistic regression and 1:1 propensity score matching. Matching was based on case-mix and preligation confounders: intraventricular hemorrhages grades 3-4, necrotizing enterocolitis, sepsis, and ≥28 days’ oxygen supply. Results Of 1389 infants, 722 (52%) had pharmacologic treatment and 156 (11.2%) received surgical ligation. Compared with infants who received pharmacologic treatment, ligated infants had greater odds for major morbidities (OR 2.09, 95% CI 1.44-3.04) and 2-year neurodevelopmental impairment (OR 1.81, 95% CI 1.15-2.84). Mortality was comparable after restricting the cohort to infants surviving at least until day 10 to avoid survival bias. In the “low” group, 34 (4.9%) of 696 infants were ligated compared with 122 (17.6%) of 693 infants in the “high” group. Infants in the “high” group had greater odds for major morbidities (OR 1.49, 95% CI 1.11-2.0). Conclusions Our analysis identified a burden on infants receiving surgical ligation vs pharmacologic treatment in a population-based setting where there was no agreed-on common procedure. These results may guide a revision of patent ductus arteriosus treatment practice in Switzerland.
    • الموضوع:
      Clinic for Neonatology; Medical Clinic; 610 Medicine & health; Pediatrics, Perinatology, and Child Health; Journal Article; PeerReviewed; info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion
    • Availability:
      Open access content. Open access content
      info:eu-repo/semantics/openAccess
      Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
      http://creativecommons.org/licenses/by-nc-nd/4.0
      info:eu-repo/semantics/openAccess
    • Note:
      application/pdf
      info:doi/10.5167/uzh-205255
      English
    • Other Numbers:
      CHUZH oai:www.zora.uzh.ch:205255
      https://www.zora.uzh.ch/id/eprint/205255/1/Adams_OutcomesFewerSurgicalLigationsPDA_jpeds_2021_Neo_USZ.pdf
      info:doi/10.5167/uzh-205255
      info:doi/10.1016/j.jpeds.2021.06.030
      info:pmid/34157348
      urn:issn:0022-3476
      1443039069
    • Contributing Source:
      HAUPTBIBLIOTHEK UNIV OF ZURICH
      From OAIster®, provided by the OCLC Cooperative.
    • الرقم المعرف:
      edsoai.on1443039069
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