ORCID Profile
0000-0003-2583-6974
Current Organisation
Princess Margaret Cancer Center
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Publisher: Springer Science and Business Media LLC
Date: 14-07-2017
Publisher: Wiley
Date: 25-03-2015
DOI: 10.1111/JPC.12863
Abstract: To compare risk-adjusted neonatal intensive care unit outcomes between regions of similar population demography and health-care systems in Australia-New Zealand and Canada to generate meaningful hypothesis for outcome improvements. Retrospective study of data from preterm infants (<32 weeks gestational age) cared for in 29 ANZNN (Australian and New Zealand Neonatal Network) and 26 Canadian Neonatal Network (CNN) intensive care unit admitted between 2005 and 2007. Moribund infants or those with major congenital malformation were excluded. The 9995 ANZNN infants had a higher gestational age (29 vs. 28 weeks, P < 0.0001), lower rate of outborn status (13.2% vs. 19.1%, P < 0.0001) and Apgar score <7 at 5 min (14.8% vs. 21.6%, P < 0.0001) than their 7141 CNN counterparts. After adjustment, ANZNN and CNN infants had a similar likelihood of survival (adjusted odds ratio (AOR) 1.01 (0.88, 1.16)), but ANZNN infants were at lower risk of severe retinopathy (AOR 0.71 (0.61, 0.83)), severe ultrasound neurological injury (AOR 0.68 (0.59, 0.78)), necrotising enterocolitis (AOR 0.65 (0.56, 0.76)), chronic lung disease (AOR 0.67 (0.62, 0.73)) and late-onset sepsis (AOR 0.83 (0.76, 0.91)). ANZNN infants were at a higher risk of pulmonary air leak (AOR 1.20 (1.01, 1.42)), early-onset sepsis (AOR 1.33 (1.02, 1.74)). More ANZNN infants received any respiratory support (AOR 1.27 (1.14, 1.41)) and continuous positive airway pressure as sole respiratory support (AOR 2.50 (2.27, 2.70)). Despite similarities in settings, ANZNN infants fared better in most measures. Outcome disparities may be related to differences in tertiary service provision, referral and clinical practices.
Publisher: S. Karger AG
Date: 20-11-2015
DOI: 10.1159/000441272
Abstract: b i Background: /i /b Very preterm infants born outside tertiary centers are at higher risks of adverse outcomes than inborn infants. Regionalization of perinatal care has been introduced worldwide to improve outcomes. b i Objective: /i /b To compare the risk-adjusted outcomes of both inborn and outborn infants cared for in tertiary neonatal intensive care units in Australia and New Zealand and in Canada. b i Methods: /i /b Deidentified data of infants weeks' gestational age from the 29 Australian and New Zealand Neonatal Network units (ANZNN n = 9,893) and 26 Canadian Neonatal Network units (CNN n = 7,133) between 2005 and 2007 were analyzed for predischarge adverse outcomes. b i Results: /i /b ANZNN had lower rates of outborns compared to CNN (13 vs. 19%), particularly of late admissions ( days of age 5.8 vs. 22.2% of outborns) who had high morbidity rates. After adjusting for confounding variables including gestation, ANZNN inborn infants had lower odds of chronic lung disease [CLD 17.0 vs. 23.3% adjusted odds ratio (AOR) = 0.70, 95% CI: 0.64-0.77], severe neurological injuries on ultrasound (SNI 4.1 vs. 6.7% AOR = 0.62, 95% CI: 0.53-0.73), severe retinopathy (5.6 vs. 7% AOR = 0.71, 95% CI: 0.59-0.84) and necrotizing enterocolitis (3.5 vs. 5.4% AOR = 0.67, 95% CI: 0.56-0.79), but no difference in mortality odds. After excluding the late outborn admissions, ANZNN outborns had lower odds of SNI (AOR = 0.43, 95% CI: 0.32-0.58) and CLD (AOR = 0.63, 95% CI: 0.49-0.81) than CNN. b i Conclusions: /i /b ANZNN inborn and early admitted outborn infants had lower odds of neonatal morbidities than their CNN counterparts. However, compared to ANZNN, the higher CNN rates of outborns and their late admissions are likely related to the differences in regionalization and referral practices, and may explain differences in outcomes.
Publisher: Elsevier BV
Date: 04-2018
Location: United States of America
No related grants have been discovered for Xiang Y. Ye.