Survival of Ventilated Extremely Premature Neonates With Sev
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Severe intraventricular hemorrhage (IVH) is a leading mortality risk factor among extremely premature neonates. Researchers performed a retrospective cohort study of mechanically ventilated neonates born at 22 to 29 weeks gestation who received care in 242 American NICUs. After building groups composed of propensity score–matched and center-matched pairs, the Cox proportional hazards analysis were used to test the hypothesis that severe IVH would be associated with greater all-cause in-hospital mortality, defined as death before transfer or discharge.

Results:
--4679 patients with severe IVH were identified.

--Among 2848 matched pairs, those with severe IVH were more likely to die compared with those without severe IVH (hazard ratio 2.79).

--Among 1527 matched pairs still hospitalized at 30 days, severe IVH was associated with greater risk of death (hazard ratio 2.03).

--Mortality associated with severe IVH varied substantially between geographic regions.

In conclusion, early detection of serious IVH is associated with all-cause in-hospital mortality in extremely premature neonates. Regional variation in extreme IVH–related mortality indicates that ultrasound-based IVH evaluation and classification has a significant impact on joint decision-making between parents and neonatologists.

Source: https://pediatrics.aappublications.org/content/147/4/e20201584?rss=1
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