Indian J Pediatr DOI 10.1007/s12098-015-1714-6
CLINICAL BRIEF
Variability in Survival of Very Low Birth Weight Neonates in Hospitals of India VLBW Infant Survival in Hospitals of India (VISHI) Study Investigators Srinivas Murki & Neeraj Kumar & Deepak Chawla & Anuradha Bansal & Ashish Mehta & Manish Shah & Swarnarekha Bhat & Suman Rao & Naveen Bajaj & Gurdev Chowdhary & Ashwani Singal & Sandeep Kadam & Naveen Jain & T. Baswaraj & Rhishikesh Thakre
Received: 11 June 2014 / Accepted: 22 January 2015 # Dr. K C Chaudhuri Foundation 2015
Abstract This prospective cohort study was conducted to evaluate variability in mortality of very low birth weight (VLBW) neonates during their birth hospitalization in different hospitals of India. A liveborn neonate was eligible for inclusion in the study if it was born or admitted in a participating hospital between 1st January and 31st December 2012 and weighed 1500g or less at birth. Neonates were given clinical care as per standard protocols. Standardized neonatal mortality ratio (SNMR) was calculated as the ratio of the observed mortality to the expected mortality. Expected mortality rate for each unit was calculated by adjusting for various prognostic factors at the time of birth or admission in the participating unit. Among 1345 neonates [mean birth weight: 1168±240g, median gestation: 30wk (IQR: 28–32)] enrolled in the study 199 (14.8%) died before hospital discharge. Although variation in inter-hospital SNMR was statistically insignificant (P 0.49), 95% CI of SNMR of most hospitals was broad reaching level of S. Murki (*) : N. Kumar Department of Pediatrics, Fernandez Hospital, Hyderabad 500001, India e-mail: [email protected] D. Chawla : A. Bansal Department of Pediatrics, Government Medical College, Chandigarh, India A. Mehta : M. Shah Department of Neonatology, Arpan Newborn Care Centre, Ahmedabad, India S. Bhat : S. Rao Department of Pediatrics, Saint John’s Medical College Hospital, Bangalore, India N. Bajaj Department of Neonatology, Deep Hospital, Ludhiana, India
clinical significance on both sides of line of equivalence. This indicates the need to establish an ongoing quality-improvement collaborative network to identify and adopt clinical practices associated with decreased mortality. Keywords Mortality . Neonate . Very low birth weight Introduction In India, very low birth weight (VLBW) infants (birth weight
CLINICAL BRIEF
Variability in Survival of Very Low Birth Weight Neonates in Hospitals of India VLBW Infant Survival in Hospitals of India (VISHI) Study Investigators Srinivas Murki & Neeraj Kumar & Deepak Chawla & Anuradha Bansal & Ashish Mehta & Manish Shah & Swarnarekha Bhat & Suman Rao & Naveen Bajaj & Gurdev Chowdhary & Ashwani Singal & Sandeep Kadam & Naveen Jain & T. Baswaraj & Rhishikesh Thakre
Received: 11 June 2014 / Accepted: 22 January 2015 # Dr. K C Chaudhuri Foundation 2015
Abstract This prospective cohort study was conducted to evaluate variability in mortality of very low birth weight (VLBW) neonates during their birth hospitalization in different hospitals of India. A liveborn neonate was eligible for inclusion in the study if it was born or admitted in a participating hospital between 1st January and 31st December 2012 and weighed 1500g or less at birth. Neonates were given clinical care as per standard protocols. Standardized neonatal mortality ratio (SNMR) was calculated as the ratio of the observed mortality to the expected mortality. Expected mortality rate for each unit was calculated by adjusting for various prognostic factors at the time of birth or admission in the participating unit. Among 1345 neonates [mean birth weight: 1168±240g, median gestation: 30wk (IQR: 28–32)] enrolled in the study 199 (14.8%) died before hospital discharge. Although variation in inter-hospital SNMR was statistically insignificant (P 0.49), 95% CI of SNMR of most hospitals was broad reaching level of S. Murki (*) : N. Kumar Department of Pediatrics, Fernandez Hospital, Hyderabad 500001, India e-mail: [email protected] D. Chawla : A. Bansal Department of Pediatrics, Government Medical College, Chandigarh, India A. Mehta : M. Shah Department of Neonatology, Arpan Newborn Care Centre, Ahmedabad, India S. Bhat : S. Rao Department of Pediatrics, Saint John’s Medical College Hospital, Bangalore, India N. Bajaj Department of Neonatology, Deep Hospital, Ludhiana, India
clinical significance on both sides of line of equivalence. This indicates the need to establish an ongoing quality-improvement collaborative network to identify and adopt clinical practices associated with decreased mortality. Keywords Mortality . Neonate . Very low birth weight Introduction In India, very low birth weight (VLBW) infants (birth weight
