Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants

BMC Pediatrics

Research Article

Brian A. Darlow¹  Prakesh S. Shah²  Shoo K. Lee²  Louise IM Koller-Smith³  Yueping A. Wang³  Sharon S. W. Chow³  Kei Lui⁴  Xiang Y. Ye⁵  Stellan Håkanson⁶  Gunnar Sjörs⁷ 

[1] Department of Paediatrics, University of Otago, Christchurch, New Zealand;Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada;Maternal Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada;Faculty of Health Science, University of Technology Sydney, Sydney, NSW, Australia;Faculty of Health Science, University of Technology Sydney, Sydney, NSW, Australia;Department of Newborn Care, Royal Hospital for Women, Barker St, 2031, Sydney, NSW, Australia;Maternal Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada;Umeå University Hospital, Umeå, Sweden;Uppsala University, Uppsala, Sweden;

关键词: Outcome;    Intensive care;    Neonatal;    Infant;    Premature;    Very low birth weight;    Small for gestational age;    Benchmarking;   

DOI  :  10.1186/s12887-017-0921-x

 received in 2015-12-07, accepted in 2017-07-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundCompared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes.MethodData from all VLGA or VLBW infants admitted in the 3 Networks between 2008 and 2011 were used. Two-thirds of each network cohort was randomly selected to develop prediction models for mortality and composite adverse outcome (CAO: mortality or cerebral injuries, chronic lung disease, severe retinopathy or necrotizing enterocolitis) and the remaining for internal validation. Areas under the ROC curves (AUC) of the models were compared.ResultsVLBW cohort (24,335 infants) had twice more SGA infants (20.4% vs. 9.3%) than the VLGA cohort (29,180 infants) and had a higher rate of CAO (36.5% vs. 32.6%). The two models had equal prediction power for mortality and CAO (AUC 0.83), and similarly for all other cross-cohort validations (AUC 0.81–0.85). Neither model performed well for the extremes of birth weight for gestation (<1500 g and ≥32 weeks, AUC 0.50–0.65; ≥1500 g and <32 weeks, AUC 0.60–0.62).ConclusionThere was no difference in prediction power for adverse outcome between cohorting VLGA or VLBW despite substantial bias in SGA population. Either cohorting practises are suitable for international benchmarking.

【 授权许可】

CC BY   
© The Author(s). 2017