Incidence of Severe Adverse Neonatal Outcomes: Use of a Composite Indicator in a Population Cohort.

The aim was to develop a composite outcome indicator to identify infants with severe adverse outcomes in routinely collected population health datasets, and assess the indicator's association with readmission and infant mortality rates. A comprehensive list of diagnoses and procedures indicative of...

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Published in:Maternal & Child Health Journal Vol. 16; no. 3; pp. 600 - 609
Main Authors: Lain, Samantha, Algert, Charles, Nassar, Natasha, Bowen, Jennifer, Roberts, Christine
Format: research tables/charts Journal Article
Published: Springer Nature Mar2012
Online Access:View this record in EBSCOhost
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      dt: Mar2012
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      pub: Springer Nature
      place: New York, New York
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        atl: Incidence of Severe Adverse Neonatal Outcomes: Use of a Composite Indicator in a Population Cohort.
      aug:
        au:
          Lain, Samantha
          Algert, Charles
          Nassar, Natasha
          Bowen, Jennifer
          Roberts, Christine
        affil: Kolling Institute of Medical Research, University of Sydney, Sydney Australia
      sug:
        subj:
          Pregnancy Outcomes
          Morbidity In Infancy and Childhood
          Infant Mortality
          Clinical Indicators
          Instrument Validation
          Resource Databases
          Human
          Pregnancy
          Female
          Infant, Newborn
          Validation Studies
          New South Wales
          Relative Risk
          Face Validity
          Readmission
          Clinical Assessment Tools
          Epidemiology
          Funding Source
          Infant, Newborn: birth-1 month
          Female
      ab: The aim was to develop a composite outcome indicator to identify infants with severe adverse outcomes in routinely collected population health datasets, and assess the indicator's association with readmission and infant mortality rates. A comprehensive list of diagnoses and procedures indicative of serious neonatal morbidity was compiled based on literature review, validation studies and expert consultation. Relevant diagnoses and procedures indicative of severe morbidity that are reliably reported were analysed and reviewed, and the neonatal adverse outcome indicator (NAOI) was refined. Data were obtained from linked birth and hospital data for 516,843 liveborn infants ≥24 weeks gestation, in New South Wales, Australia from 2001 to 2006. Face validity of the indicator was examined by calculating the relative risks (and 95% CI) of hospital readmission or death in the first year of life of those infants identified by the NAOI. Overall 4.6% of all infants had one or more conditions included in the NAOI; 35.4% of preterm infants and 2.4% of term infants. Infants identified by the composite indicator were 10 times more likely to die in the first year of life and twice as likely to be readmitted to hospital in the first year of life compared to infants not identified by the NAOI. The NAOI can reliably identify infants with a severe adverse neonatal outcome and can be used to monitor trends, assess obstetric and neonatal interventions and the quality of perinatal care in a uniform and cost-effective way.
      pubtype: Academic Journal
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        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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