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, Vol.110(1), pp.10-16
01/2025
DOI: 10.1136/archdischild-2024-327084
PMID: 38697810
Abstract
Objective 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). Design Cohort study of the Children's Hospitals Neonatal Database from 2010 to 2022. Setting 41 referral neonatal intensive care units (NICUs) in North America. Patients Infants born before 32 weeks' gestation with PHH defined as acquired hydrocephalus with intraventricular haemorrhage. Interventions (1) No intervention, (2) temporising device (TD) only, (3) initial permanent shunt (PS) and (4) TD followed by PS (TD-PS). Main outcome measures Mortality and meningitis. Results 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. Conclusions 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%.
Details
- Title: Subtitle
- 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–MilwaukeeIsabella Zaniletti - Childrens Hosp Neonatal Consortium, Dover, DE USADan Couture - Wake Forest UniversityNarendra Dereddy - University of Central FloridaCarl H. Coghill - Children's of AlabamaTracy M. Flanders - Children's Hospital of PhiladelphiaAndrew Foy - University of Wisconsin–MilwaukeeGregory 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 WashingtonEylem Ocal - University of Arkansas for Medical SciencesMichael A. Padula - Children's Hospital of PhiladelphiaCherrie D. Welch - Wake Forest UniversityBernadette White - Cook Children's Medical CenterDiane Wilson - Hospital for Sick ChildrenJohn Flibotte - Children's Hospital of PhiladelphiaChildren’s Hospitals Neonatal Consortium Neurosurgery Focus Group
- Resource Type
- Journal article
- Publication Details
- Archives of disease in childhood. Fetal and neonatal edition, Vol.110(1), pp.10-16
- Publisher
- Bmj Publishing Group
- DOI
- 10.1136/archdischild-2024-327084
- PMID
- 38697810
- ISSN
- 1359-2998
- eISSN
- 1468-2052
- Number of pages
- 7
- Grant note
- Children's National Hospital Houston, Texas Children's Hospital Boston Children's Hospital Pittsburgh Children's Hospital Wisconsin Children's Hospital (Joanne Lagatta) Omaha Children's Hospital (Nicole Birge) Nemours Children's Hospital Children's Hospital of Philadelphia Mayo Clinic Children's Little Rock, Arkansas Children's (Laura Carroll) Seattle Children's Hospital Iowa City, University of Iowa Stead Family Children's Hospital Orange County, Children's Hospital of Orange County Primary Children's Hospital Ann & Robert H Lurie Children's Hospital San Diego, Rady Children's Hospital Cook Children's Healthcare System (Annie Chi) Cleveland Clinic Hospital for Sick Children Children's Minnesota 43 / St Paul, Children's Minnesota Columbus, Nationwide Children's Hospital Children's Mercy Hospital American Family Children's Hospital St Christopher's Hospital for Children St Louis Children's Hospital Oklahoma Children's Hospital Phoenix Children's Hospital Los Angeles Children's Hospital Nemours/Alfred I duPont Hospital for Children Le Bonheur Children's Hospital Children's Medical Center Winston-Salem, Brenner Children's Hospital Children's Hospital Colorado Detroit, Children's Hospital Michigan Cincinnati Children's Hospital
- Language
- English
- Electronic publication date
- 05/02/2024
- Date published
- 01/2025
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984695828302771
Metrics
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