对一个地区的极低出生体重婴儿的数据收集:方法、费用以及死亡率、住院率趋势和5年期间的资源利用情况

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Aims:1.To determine the survival and morbidity of infants at discharge with a birthweight of less than 1500 g in the geographically defined population of Ea st Anglia.2.To demonstrate a cost-effective method of regional data collectio n.3.To determine whether there were any changes in the demand for neonatal car e.Study design and subjects:A prospective cohort analysis using a single datab ase to collect data on 1244 very low birthweight infants from eight neonatal uni ts in one Region from 1993 to 1997.Results:Estimated ascertainment of VLBW inf ants to the study was 96%.Over the 5 years survival rates were stable(75-79 %).52%of deaths in infants admitted for neonatal care occurred on day 1,with just 15%of deaths occurring after 28 days of life.Mortality risk significantl y decreased with increasing gestational age at birth.Compared to 22-25-week o ld infants,the mortality risk decreased by 65%for 26-27-week old infants(OR 0.35 95%CI(0.21,0.59))and by 92%for 32-39-week old infants(OR 0.08 95% CI(0.03,0.21))with intermediate odds ratios of 0.22(0.12,0.42)and 0.13(0.06,0.28)for the 28-29 and 30-39 weeks gestation,respectively.Higher birthw eight,after adjusting for gestation also decreased the mortality risk(OR 0.78 per 100 g difference,95%CI(0.71,0.86)).No change was seen in the number of extremely preterm infants admitted for intensive care or resource utilisation,a lthough a significant increase was seen in the number of infants dying in delive ry rooms.There was a reduction in the reported incidence of pulmonary interstit ial emphysema(10-4%)but no change in the number of ventilation days or the r ate of chronic lung disease.The mean maternal age increased from 27.7 years to 28.9 years during the study.Maternal steroid administration increased(30%to 5 9%)and was associated with a decreased risk of mortality(OR 0.44,95%CI:0.3 1-0.62).Conclusions:It is possible to collect useful data from the neonatal p eriod at a reasonable cost from a geographically defined population.This inform ationwas used for informing clinicians,counselling parents and in the era of ma naged clinical networks will be useful in guiding the provision of effective hea lth care resources. Aims: 1.To determine the survival and morbidity of infants at discharge with a birthweight of less than 1500 g in the geographically defined population of Ea st Anglia.2.To demonstrate a cost-effective method of regional data collectio n.3.To determine whether there any any changes in the demand for neonatal car e. Study design and subjects: A prospective cohort analysis using a single databse to collect data on 1244 very low birthweight infants from eight neonatal uni ts in one Region from 1993 to 1997. Results: Estimated ascertainment of VLBW infants to the study was 96%. Over the 5 years survival rates were stable (75-79%). 52% of deaths in infants admitted for neonatal care occurred on day 1, with just 15% of Deaths occurring after 28 days of life. MORTality risk significantl y decreased with increasing gestational age at birth. Compared to 22-25-week o ld infants, the mortality risk decreased by 65% ​​for 26-27-week old infants (OR 0.35 95 % CI (0.21,0.59)) and by 92% for 32-39-week old infants (OR 0.08 95% CI (0.03,0.21)) with intermediate odds ratios of 0.22 (0.12,0.42) and 0.13 (0.06,0.28) for the 28-29 and 30-39 weeks gestation, respectively. Height birth eight, after adjusting for gestation also decreased the mortality risk (OR 0.78 per 100 g difference, 95% CI (0.71, 0.86)). No change was seen in the number of extremely preterm infants admitted for intensive care or resource utilizations, a lthough a significant increase was seen in the number of infants dying in delive ry rooms. where was a reduction in the reported incidence of pulmonary interstitial emphysema (10-4%) but no change in the number of ventilation days or the r ate of chronic lung disease. the mean maternal Age increased from 27.7 years to 28.9 years during the study. Maternal steroid administration increased (30% to 59%) and was associated with a decreased risk of mortality (OR 0.44,95% CI: 0.3 1-0.62) .Conclusions: It is possible to collect useful data from the neonatal p eriod at a reasonable cost from a geographically defined populinformtion of the use of informing clinicians, counseling parents and in the era of ma naged clinical networks will be useful in guiding the provision of effective heal care resources.
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