ImportanceRetinopathy of prematurity (ROP) is a potentially blinding retinal disease with poorly defined epidemiology. Understanding of which infants are most at risk for developing ROP may foster targeted detection and prevention efforts.ObjectiveTo identify changes in ROP incidence in the US from 2003 to 2019.Design, Setting, and ParticipantsThis retrospective database cohort study used the Healthcare Cost and Utilization Project Kids’ Inpatient Databases. These nationwide databases are produced every 3 years, include data from over 4000 hospitals, and are designed to generate national estimates of health care trends in the US. Participants included pediatric newborns at risk for ROP development between 2003 and 2019. Data were analyzed from September 30, 2021, to January 13, 2022.ExposuresPremature or low-birth-weight infants with relevant International Classification of Diseases, Ninth Revision or Tenth Revision codes were considered ROP candidates. Infants with ROP were identified using relevant codes.Main Outcomes and MeasuresROP incidence in selected subpopulations (based on database-reported race and ethnicity, sex, location, income) was measured. To determine whether incidences varied across time or subpopulations, χ2 tests of independence were used.ResultsThis study included 125 212 ROP discharges (64 715 male infants [51.7%]) from 23 187 683 births. The proportion of premature infants diagnosed with ROP increased from 4.4% (11 720 of 265 650) in 2003 to 8.1% (27 160 of 336 117) in 2019. Premature infants from the lowest median household income quartile had the greatest proportional increase of ROP diagnoses from 4.9% (3244 of 66 871) to 9.0% (9386 of 104 235; P < .001). Premature Black infants experienced the largest increase from 5.8% (2124 of 36 476) to 11.6% (7430 of 63 925; P < .001) relative to other groups (2.71%; 95% CI, 2.56%-2.87%; P < .001). Hispanic infants experienced the second largest increase from 4.6% (1796 of 39 106) to 8.2% (4675 of 57 298; P < .001) relative to other groups (−0.16%; 95% CI, −0.29% to −0.03%; P = .02). The Southern US experienced the greatest proportional growth of ROP diagnoses, increasing from 3.7% (3930 of 106 772) to 8.3% (11 952 of 144 013; P < .001) relative to other groups (1.61%; 95% CI, 1.51%-1.71%; P < .001). ROP diagnoses proportionally increased in urban areas and decreased in rural areas.Conclusions and RelevanceThis cohort study found that ROP incidence among premature infants increased from 2003 to 2019, especially among Black and Hispanic infants. Infants from the lowest-income areas persistently had the highest proportional incidence of ROP, and all regions experienced a significant increase in ROP incidence with the most drastic changes occurring in the South. These trends suggest that ROP is a growing problem in the US and may be disproportionately affecting historically marginalized groups.

There have been conflicting data regarding liver transplantation (LT) outcomes for hereditary hemochromatosis (HH), with no recent data on LT outcomes in patients with HH in the past decade. Using the United Network for Organ Sharing registry, we evaluated waitlist and post‐LT survival in all adult patients listed for HH without concomitant liver disease from 2003 to 2019. Post‐LT survival for HH was compared with a propensity‐matched (recipient and donor factors) cohort of recipients with chronic liver disease (CLD). From 2003 to 2019, 862 patients with HH were listed for LT, of which 55.6% (n = 479) patients underwent LT. The 1‐ and 5‐year post‐LT survival rates in patients with HH were 88.7% (95% confidence interval [CI], 85.4%–91.4%) and 77.5% (95% CI, 72.8%–81.4%), respectively, and were comparable with those in the propensity‐matched CLD cohort (p value = 0.96). Post‐LT survival for HH was lower than for Wilson's disease, another hereditary metabolic liver disease with similar LT volume (n = 365). Predictors for long‐term (5‐year) post‐LT mortality included presence of portal vein thrombosis (hazard ratio [HR], 1.96; 95% CI, 1.07–3.58), obesity measurements greater than Class II (HR, 1.98; 95% CI, 1.16–3.39), and Karnofsky performance status (HR, 0.98; 95% CI, 0.97–0.99) at the time of LT. The leading cause of post‐LT death (n = 145) was malignancy (25.5%), whereas cardiac disease was the cause in less than 10% of recipients. In conclusion, short‐ and long‐term survival rates for HH are excellent and comparable with those of other LT recipients. Improving extrahepatic metabolic factors and functional status in patients with HH prior to LT may improve outcomes.

We report full recovery of a patient with hypothermia in cardiac arrest following continuous and prolonged cardiopulmonary resuscitation (CPR) and conventional, nonextracorporeal life support (non-ECLS) methods. A 57-y-old man presented with unwitnessed cardiac arrest and a core temperature of 23 • C (73 • F). The presenting cardiac rhythm was ventricular fibrillation. The team administered epinephrine and performed defibrillation and CPR. Because ECLS was unavailable at the facility, the medical team externally and internally rewarmed the patient using heated blankets, forced warmed air, thoracic lavage, and warmed IV fluids. The patient achieved return of spontaneous circulation after 4 h 56 min of continuous CPR and rewarming. The medical team admitted the patient to the intensive care unit. He achieved full neurologic recovery the following day. When ECLS is not available and transfer is not appropriate because of patient instability or hospital location, conventional rewarming methods and continuous, prolonged CPR can lead to successful outcomes in patients with hypothermia in cardiac arrest. This case demonstrates that CPR in patients with hypothermia-associated cardiac arrest can lead to full recovery.

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