新生儿脑室内出血发病率和死亡率的地区差异:国家数据库分析。

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Child's Nervous System Pub Date : 2024-11-01 Epub Date: 2024-07-03 DOI:10.1007/s00381-024-06514-5
Sumaiya Sayeed, Brianna C Theriault, Astrid C Hengartner, Paul Serrato, Sina Sadeghzadeh, Selma Belkasim, Nabihah Ahsan, Emad A Elsamadicy, Michael DiLuna, Aladine A Elsamadicy
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引用次数: 0

摘要

背景:脑室内出血(IVH)通常会影响低胎龄和低出生体重的新生儿,需要对新生儿进行重症监护,并与长期神经发育结果有关。评估美国各地区在新生儿 IVH 护理及后续预后方面的差异,可以揭示缩小社会经济差异的方法:方法:利用2016-2019年全国住院患者样本(NIS),使用ICD-10-CM代码确定主要诊断为IVH的患者。根据医院所在地区对患者进行分层,开展了一项回顾性队列研究。对患者的人口统计学特征、合并症、发病情况、术中变量和住院结果进行了评估。使用多变量逻辑回归分析确定保险状况对延长的住院时间(定义为大于住院时间第 75 百分位数)、高昂的费用(定义为大于费用第 75 百分位数)和死亡率的影响:本研究包括 1630 例 IVH 新生儿。与东北部和西部相比,南部和中西部的患者中有更多的黑人(东北部:12.2% vs 中西部:30.2% vs 南部:22%):东北部:12.2% vs 中西部:30.2% vs 南部:22.8% vs 西部:5.8%,P 结论:不同地区的人口统计学变量存在差异,但术前或术中变量没有差异,这表明可能存在地域健康差异。西部地区的入院总费用最高,而南部地区入院费用过高的几率较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Regional variations in morbidity and mortality among neonates with intraventricular hemorrhage: a national database analysis.

Regional variations in morbidity and mortality among neonates with intraventricular hemorrhage: a national database analysis.

Background: Intraventricular hemorrhage (IVH) often affects newborns of low gestational age and low birth weight, requires critical care for neonates, and is linked to long-term neurodevelopmental outcomes. Assessing regional differences in the U.S. in care for neonatal IVH and subsequent outcomes can shed light on ways to mitigate socioeconomic disparities.

Methods: Using the 2016-2019 National Inpatient Sample (NIS), patients with a primary diagnosis of IVH were identified using ICD-10-CM codes. A retrospective cohort study was conducted with patients stratified by hospital region. Demographics, comorbidities, presentation, intraoperative variables, and inpatient outcomes were assessed. Multivariate logistic regression analyses were used to identify the impact of insurance status on extended LOS (defined as > 75th percentile of LOS), exorbitant cost (defined as > 75th percentile of cost), and mortality.

Results: Included in this study were 1630 newborns with IVH. A larger portion of patients in the South and Midwest were Black, compared to the Northeast and West (Northeast: 12.2% vs Midwest: 30.2% vs South: 22.8% vs West: 5.8%, p < 0.001), while a greater percentage of patients in the West and South were Hispanic (Northeast: 7.3% vs Midwest: 9.5% vs South: 22.8% vs West: 36.2%, p < 0.001). LOS was similar among all regions. Factors associated with prolonged LOS included hydrocephalus and CSF diversions. Median total cost of admission was highest in the West, while the South was associated with decreased odds of exorbitant cost. LOS was associated with exorbitant cost, and large bed-volume hospital, VLBW, and permanent CSF shunt were associated with mortality.

Conclusions: Demographic variables, but not presenting or intraoperative variables, differed among regions, pointing to possible geographic health disparities. The West had the highest total cost of admission, while the South was associated with reduced odds of exorbitant admission costs.

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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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