Trends in hospitalization of preterm infants with intraventricular hemorrhage and hydrocephalus in the United States, 2000–2010

Abstract

<jats:sec> <jats:title>OBJECT</jats:title> <jats:p>Even with improved prenatal and neonatal care, intraventricular hemorrhage (IVH) occurs in approximately 25%–30% of preterm infants, with a subset of these patients developing hydrocephalus. This study was undertaken to describe current trends in hospitalization of preterm infants with posthemorrhagic hydrocephalus (PHH) using the Nationwide Inpatient Sample (NIS) and the Kids’ Inpatient Database (KID).</jats:p></jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>The KID and NIS were combined to generate data for the years 2000–2010. All neonatal discharges with ICD-9-CM codes for preterm birth with IVH alone or with IVH and hydrocephalus were included.</jats:p></jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>There were 147,823 preterm neonates with IVH, and 9% of this group developed hydrocephalus during the same admission. Of patients with Grade 3 and 4 IVH, 25% and 28%, respectively, developed hydrocephalus in comparison with 1% and 4% of patients with Grade 1 and 2 IVH, respectively. Thirty-eight percent of patients with PHH had permanent ventricular shunts inserted. Mortality rates were 4%, 10%, 18%, and 40%, respectively, for Grade 1, 2, 3, and 4 IVH during initial hospitalization. Length of stay has been trending upward for both groups of IVH (49 days in 2000, 56 days in 2010) and PHH (59 days in 2000, 70 days in 2010). The average hospital cost per patient (adjusted for inflation) has also increased, from $201,578 to $353,554 (for IVH) and $260,077 to $495,697 (for PHH) over 11 years.</jats:p></jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>The number of neonates admitted with IVH has increased despite a decrease in the number of preterm births. Rates of hydrocephalus and mortality correlated closely with IVH grade. The incidence of hydrocephalus in preterm infants with IVH remained stable between 8% and 10%. Over an 11-year period, there was a progressive increase in hospital cost and length of stay for preterm neonates with IVH and PHH that may be explained by a concurrent increase in the proportion of patients with congenital cardiac anomalies.</jats:p></jats:sec>

Big Data Research in Pediatric Neurosurgery: Content, Statistical Output, and Bibliometric Analysis

“…Big data can provide information on the associations of hospital type, provider caseload, and geography with outcomes, as has been nicely done for pediatric brain tumors, shunt surgery, and cerebrovascular pathology [37, 38, 45]. Also relevant would be their use in studies of epidemiologic, socioeconomic, or demographic questions, as they pertain to changes over time (trend analysis), for which there are a number of excellent examples [22, 23, 46-50]. …”

Factores Asociados a Hemorragia Intraventricular En Neonatos Atendidos En Un Hospital de Segundo Nivel

“…Este grupo de pacientes presentan las mayores tasas de comorbilidad global y neurológica y, en consecuencia, es objeto de mayor preocupación por parte de obstetras, neonatólogos, las familias y la sociedad en conjunto (Euson, 2012). Por otra parte las complicaciones respiratorias como el síndrome de distres respiratorio y displasia broncopulmonar contribuyen a un peor pronóstico y hospitalización más prolongada en la UCIN (Christian et al, 2016).…”

“…El 56% de los pacientes con HIV en un estudio americano son varones. El 41% de los neonatos prematuros con HIV tuvieron un peso al nacer entre 500 a 999 g. El grupo racial con mayor número de casos fueron los blancos (34%), seguido de los niños negros (19%) y los hispanos (15%) (Christian et al, 2016).…”

“…Los vasos en esta región ocupan zonas limítrofes entre las arterias cerebrales y el área de drenaje de las venas cerebrales profundas. Además, la permeabilidad aumenta en situaciones de hipoxia o ante el incremento de la presión venosa (Christian et al, 2016).…”

The Survey of Magnesium Sulfate in Prevention of Intraventricular Hemorrhage in Premature Infants: A Randomized Clinical Trial

“…Factors such as respiratory distress, hypoxia-related injury, ischemia, blood pressure decrease or increase, increased venous pressure, pneumothorax, and hypovolemia would increase the probability of IVH. This side effect may occur in the first 72 hours of birth; half of the cases are seen in the first day of life, and more than 90% of cases may be seen up to end of the first week (1)(2)(3)(4). IVH and periventricular hemorrhage are seen in 50% of VLBW neonates and in those younger than 35 weeks in the United States although the rate recently has decreased.…”