Journal article
Surgical interventions and short-term outcomes for preterm infants with post-haemorrhagic hydrocephalus: a multicentre cohort study
Archives of disease in childhood. Fetal and neonatal edition
02 May 2024
PMID: 38697810
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To (1) describe differences in types and timing of interventions, (2) report short-term outcomes and (3) describe differences among centres from a large national cohort of preterm infants with post-haemorrhagic hydrocephalus (PHH).
Cohort study of the Children's Hospitals Neonatal Database from 2010 to 2022.
41 referral neonatal intensive care units (NICUs) in North America.
Infants born before 32 weeks' gestation with PHH defined as acquired hydrocephalus with intraventricular haemorrhage.
(1) No intervention, (2) temporising device (TD) only, (3) initial permanent shunt (PS) and (4) TD followed by PS (TD-PS).
Mortality and meningitis.
Of 3883 infants with PHH from 41 centres, 36% had no surgical intervention, 16% had a TD only, 19% had a PS only and 30% had a TD-PS. Of the 46% of infants with TDs, 76% were reservoirs; 66% of infants with TDs required PS placement. The percent of infants with PHH receiving ventricular access device placement differed by centre, ranging from 4% to 79% (p<0.001). Median chronological and postmenstrual age at time of TD placement were similar between infants with only TD and those with TD-PS. Infants with TD-PS were older and larger than those with only PS at time of PS placement. Death before NICU discharge occurred in 12% of infants, usually due to redirection of care. Meningitis occurred in 11% of the cohort.
There was significant intercentre variation in rate of intervention, which may reflect variability in care or referral patterns. Rate of PS placement in infants with TDs was 66%.
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Details
- Title
- Surgical interventions and short-term outcomes for preterm infants with post-haemorrhagic hydrocephalus: a multicentre cohort study
- Creators
- Elizabeth Sewell - Children's Healthcare of AtlantaSusan Cohen - University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USAIsabella Zaniletti - The Children's Hospitals Neonatal Consortium, Dover, Delaware, USADan Couture - Wake Forest UniversityNarendra Dereddy - University of Central Florida College of Medicine, Orlando, Florida, USACarl H Coghill - University of Alabama at BirminghamTracy M Flanders - Children's Hospital of PhiladelphiaAndrew Foy - University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USAGregory G Heuer - Children's Hospital of PhiladelphiaEni Jano - Children's Hospital of Los AngelesNicole Kemble - Children's Hospital of PhiladelphiaStephanie Lee - University of Iowa Health CareCon Yee Ling - Primary Children's HospitalShadi Malaeb - Drexel UniversityUlrike Mietzsch - University of Washington School of MedicineEylem Ocal - University of Arkansas for Medical SciencesMichael A Padula - Children's Hospital of PhiladelphiaCherrie D Welch - Wake Forest School of Medicine, Winston-Salem, North Carolina, USABernadette White - Cook Children's Medical CenterDiane Wilson - Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, CanadaJohn Flibotte - Children's Hospital of PhiladelphiaChildren’s Hospitals Neonatal Consortium Neurosurgery Focus Group
- Publication Details
- Archives of disease in childhood. Fetal and neonatal edition
- Publisher
- British Medical Journal (BMJ)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:001222030200001
- Scopus ID
- 2-s2.0-85192709153
- Other Identifier
- 991021874413904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics