Wasted Health Care Dollars

Leistikow, Elizabeth A.

doi:10.1001/archpedi.1995.02170230101015

Cited by 21 publications

(2 citation statements)

References 8 publications

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“…12 Studies have shown that unselective DAT testing for all infants is not cost-effective. 12,13 The authors of these studies concluded that selective newborn cord testing of neonates born to mothers with blood group O is feasible and can decrease hospital costs without increasing the risk of HDN. Resources and costs, as a result, would be saved without increasing the risk of clinically significant hyperbilirubinemia.…”

mentioning

confidence: 99%

Value of the Direct Antiglobulin Test in Predicting the Need for Phototherapy in Newborns

AlKhater¹,

Albalwi²,

Alomar³

et al. 2021

JBM

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Purpose Guidelines for managing neonatal hemolytic disease of the newborn (HDN) recommend a selective approach in the use of direct antiglobulin test (DAT). In Saudi Arabia, many hospitals still perform routine DAT for all newborns. This study assessed the need for phototherapy in relation to DAT results in full-term healthy newborns. Patients and Methods A retrospective analysis of all healthy newborns admitted during 2018 was performed. The primary outcome was the association of positive DAT results with phototherapy. Results There were 1463 newborns born during the study period. The DAT was positive at 4.4%. The 24-hour bilirubin levels were higher in DAT-positive cases ( P =0.06); however, peak bilirubin levels were not correlated with the DAT results ( P =0.717). Thirty-six neonates (2.46%) required phototherapy, and the need was similar among DAT-positive and DAT-negative cases ( P =0.271). The most common indication for phototherapy was clinical jaundice in 22 neonates (61.1%), followed by DAT positivity in 12 (33.3%) and hospital protocol in 2 patients (5.6%) ( P <0.01 by chi-square overall comparison). Conclusion Our results indicate that factors other than DAT positivity are important in assessing the need for phototherapy in newborns. Clinical signs of jaundice were indicators of high serum bilirubin levels and subsequent phototherapy, further indicating that the DAT test was overused in predicting the need for phototherapy.

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mentioning

confidence: 99%

Value of the Direct Antiglobulin Test in Predicting the Need for Phototherapy in Newborns

AlKhater¹,

Albalwi²,

Alomar³

et al. 2021

JBM

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“…On the other hand, there are studies reporting that the bilirubin level in cord blood alone is more determinative and sufficient in determining the risk of developing hyperbilirubinemia. 13 The results in our study show that newborns with positive direct Coombs'test have higher UCB levels than those who are negative, and they need more phototherapy. Our results support the hypothesis that cord blood direct Coombs'test results are useful in early detection of cases with high risk of developing hyperbilirubinemia.…”

Section: Discussionmentioning

confidence: 52%

Can Phototherapy Requirements Be Predicted through Cord Blood Test Results in Newborns?

Hekimoğlu¹

2020

J. Pediatr. Acad.

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Objective: Hyperbilirubinemia is one of the common problems in newborns. If not diagnosed and treated in time, high bilirubin levels can cause kernicterus and permanent brain damage. Therefore, early detection of hyperbilirubinemia development risk in newborns is important. Our aim is to determine whether the cord blood bilirubin level and the direct coombs test can be used as determinant parameters in order to predict babies with a high risk of developing hyperbilirubinemia requiring treatment. Material and Method: During the process of creating a hyperbilirubinemia follow-up protocol at Ordu University Training and Research Hospital, 300 babies born between January -June 2014with a birth weight ≥ 2500 g and gestational week ≥ 37 weeks were included in the study. The results of the cord blood bilirubin in of these babies, direct coombs test, maternal and infant blood groups and serum bilirubin levels of those who were hospitalized for phototherapy treatment within the first 24 hours were analyzed retrospectively. Results: Phototherapy was given to 35 of 300 (11.7%) newborns included in the study within the first 24 hours after birth. Direct coombs test was positive in 25 of them (8.3%). Phototherapy was given to 80% (n: 20) of the cases whose direct coombs test was positive. ABO incompatibility was found in the etiology of 51.5% of the cases with hyperbilirubinemia. It has been observed that patients with positive direct coombs test have a high rate of hospitalization (p<0.001). Cord blood bilirubin levels were found to be statistically higher in cases who received phototherapy (2.7±1.0 and 1.8±0.6, respectively, p<0.01). In determining the need for phototherapy, sensitivity was 77.1%, specificity was 77.0%, and negative predictive value was 96% for the cut off value of 2.0 mg/dl of cord blood bilirubin. Conclusion: Cord blood bilirubin level and direct coombs test are useful in predicting the possibility of pathological hyperbilirubinemia and hospitalization in newborns. Thus, detection of risky newborns with a noninvasive method within a few hours after birth will prevent early discharge and provide close follow-up and early treatment.

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Hour-Specific Bilirubin Nomogram in Infants With ABO Incompatibility and Direct Coombs-Positive Results

Schutzman¹,

Sekhon²,

Hundalani³

2010

Arch Pediatr Adolesc Med

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Wasted Health Care Dollars

Cited by 21 publications

References 8 publications

Value of the Direct Antiglobulin Test in Predicting the Need for Phototherapy in Newborns

Value of the Direct Antiglobulin Test in Predicting the Need for Phototherapy in Newborns

Can Phototherapy Requirements Be Predicted through Cord Blood Test Results in Newborns?

Hour-Specific Bilirubin Nomogram in Infants With ABO Incompatibility and Direct Coombs-Positive Results

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