scholarly journals Validation of perinatal data in the Discharge Abstract Database of the Canadian Institute for Health Information

2009 ◽  
Vol 29 (3) ◽  
pp. 96-101 ◽  
Author(s):  
K.S. Joseph ◽  
J. Mahey
Keyword(s):  
Health Information ◽  
Intraventricular Hemorrhage ◽  
Distress Syndrome ◽  
Sensitivity Analyses ◽  
Perinatal Morbidity ◽  
Discharge Abstract Database ◽  
Canadian Institute ◽  
Perinatal Data ◽  
Improved Accuracy ◽  
Perinatal Database

We compared perinatal information submitted to the Canadian Institute for Health Information (CIHI) hospitalization database with information submitted to the Nova Scotia Atlee Perinatal Database (NSAPD) in order to assess the accuracy of the CIHI data. Procedures such as Caesarean delivery were coded accurately (i.e. sensitivity of 99.8%; specificity of 98.7%). Postpartum hemorrhage, induction of labour and severe intraventricular hemorrhage also had sensitivity and specificity rates above 85% and 95%, respectively. Some diagnoses, defined differently in the two databases, were less accurately coded, e.g. respiratory distress syndrome (RDS) had a sensitivity of 50.9% and a specificity of 99.8%. Restriction to more severe forms of the disease improved accuracy, e.g. restriction of RDS to severe RDS in the NSAPD and identification of severe RDS in the CIHI database, using codes for RDS and intubation, resulted in a sensitivity of 100% and a specificity of 99.6%. Our study supports the use of CIHI data for national surveillance of perinatal morbidity, with the caveat that an understanding of clinical practice and sensitivity analyses to identify robust findings be used to facilitate inference.

Validating a Statewide Data Collection: Differences in Information Technology Resources between Hospitals

1997 ◽  
Vol 27 (2) ◽  
pp. 67-68 ◽  
Author(s):  
Merilyn Riley ◽  
Odette Griffin
Keyword(s):  
Information Technology ◽  
Data Collection ◽  
Health Information ◽  
Medical Record ◽  
The State ◽  
Data Accuracy ◽  
Perinatal Morbidity ◽  
Perinatal Data ◽  
Technology Resources

The Victorian Perinatal Data Collection Unit (VPDCU) is a statewide data collection established to collect information on the health of mothers and their babies. A Perinatal Morbidity Statistics Form is required to be completed for every birth, then forwarded to the VPDCU. Many medical record departments are responsible for both forwarding the forms to the VPDCU and responding to queries on data accuracy. In 1996 we undertook to determine if we were receiving a perinatal form for every birth occurring at every hospital in the State with obstetric beds. Health information managers were requested to supply a listing of all babies born at their hospitals in 1995 — 129 hospitals responded. Overall 62,759 births were validated. The VPDCU had received a perinatal form for 99.6 per cent of these births, with 251 missing forms. Reasons why the VPDCU had not received the forms were investigated.

A Controlled Trial of Hydrocortisone Therapy in Infants With Respiratory Distress Syndrome: II. Pathology

PEDIATRICS ◽  
1973 ◽  
Vol 52 (6) ◽  
pp. 850-854 ◽  
Author(s):  
H. William Taeusch ◽  
Nai San Wang ◽  
Melvin Baden ◽  
Charles R. Bauer ◽  
Leo Stern
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Beneficial Effect ◽  
Intraventricular Hemorrhage ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Clinical Results ◽  
Steroid Treatment ◽  
Pathological Findings

The pathological findings from seven infants who died with respiratory distress syndrome and had been treated with placebo are compared with seven infants with comparable disease treated with hydrocortisone. Differences in lung, liver, adrenal, thymus, heart and spleen pathology attributable to steroid treatment did not occur between the two groups. A statistically significant association was found between intraventricular hemorrhage and steroid treatment. The pathological findings are consistent with the clinical results in that no beneficial effect occurs when steroids are used after an infant manifests respiratory distress. The possibility that elevated steroid levels increase the likelihood of intraventricular hemorrhage in association with respiratory distress syndrome is raised by these observations, although further information is needed to establish such a relationship.

scholarly journals Antenatal Corticosteroids and Preterm Neonatal Morbidity and Mortality among Women with and without Diabetes in Pregnancy

2020 ◽  
Author(s):  
Ashley N. Battarbee ◽  
Grecio Sandoval ◽  
William A. Grobman ◽  
Jennifer L. Bailit ◽  
Uma M. Reddy ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Neonatal Morbidity ◽  
Maternal Diabetes ◽  
Differential Association ◽  
Sensitivity Analyses ◽  
Antenatal Corticosteroid ◽  
Antenatal Corticosteroids

Objective The objective of this study was to determine whether antenatal corticosteroid exposure has a differential association with preterm neonatal morbidity among women with and without diabetes. Study Design Secondary analysis of an observational cohort of 115,502 women and their neonates born in 25 U.S. hospitals (2008–2011). Women who delivered at 230/7 to 336/7 weeks' gestation and received antenatal corticosteroids were compared with those who did not receive antenatal corticosteroids. Women with a stillbirth and women who delivered a neonate that was not resuscitated were excluded. The primary outcome was neonatal respiratory distress syndrome or death within 48 hours. Secondary outcomes included composite neonatal morbidity (respiratory distress syndrome, necrotizing enterocolitis, grades 3–4 intraventricular hemorrhage, sepsis, or death) and mechanical ventilation. Multivariable modified Poisson regression was used to estimate the association between antenatal corticosteroid exposure and neonatal outcomes. Maternal diabetes (pregestational and gestational) was evaluated as a potential effect modifier, and sensitivity analyses were conducted to evaluate whether receipt of a partial, single, or multiple course(s) of antenatal corticosteroids influenced results. Results A total of 4,429 women with 5,259 neonates met inclusion criteria: 3,716 (83.9%) women received antenatal corticosteroids and 713 (16.1%) did not. Of the 510 diabetic women (181 pregestational and 329 gestational), 439 (86.1%) received antenatal corticosteroids. Of the 3,919 nondiabetic women, 3,277 (83.6%) received antenatal corticosteroids. Antenatal corticosteroid exposure was not associated with respiratory distress syndrome or early death (adjusted relative risk [aRR] = 0.94, 95% confidence interval [CI]: 0.85–1.04), composite neonatal morbidity (aRR = 0.98, 95% CI: 0.89–1.07), or mechanical ventilation (aRR = 0.95, 95% CI: 0.86–1.05). There was no significant effect modification of maternal diabetes on the relationship between antenatal corticosteroids and neonatal outcomes (p > 0.05), and outcomes were similar in sensitivity analyses of partial, single, or multiple courses of corticosteroids. Discussion Antenatal corticosteroid administered to reduce preterm neonatal morbidity does not appear to have a differential association among women with diabetes compared with those without. Key Points

Effect of gender on growth-restricted fetuses born preterm

2019 ◽  
Vol 47 (6) ◽  
pp. 677-679
Author(s):  
Tea Štimac ◽  
Ana-Maria Šopić-Rahelić ◽  
Jelena Ivandić ◽  
Eduard Ekinja ◽  
Isaac Blickstein
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intraventricular Hemorrhage ◽  
Distress Syndrome ◽  
Inclusion Criteria ◽  
Male And Female ◽  
Fetal Gender ◽  
Maternal And Neonatal Outcomes ◽  
Males And Females ◽  
Similar Incidence

Abstract Objective To assess the effect of fetal gender in small-for-gestational age (SGA) neonates with birth weight less than the fifth percentile by gestational age. Methods We compared male and female SGA neonates for maternal and neonatal outcomes in the following gestational age subgroups: at <32 + 6, 33 + 0–36 + 6 and at ≥37 + 0 weeks of gestation. Results We examined 159, 154 and 2363 SGA neonates born at <32 + 6, 33 + 0 to 36 + 6 and ≥37 weeks of pregnancy, respectively, whose birth weight was below the fifth percentile for gestational age and who met our inclusion criteria. Overall, there were no significant differences between the mothers of males and females, except that there were more males at term and the incidence of nulliparas was greater among the mothers of males. In terms of outcomes, males had a similar incidence of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH) and admissions to intensive care. Interestingly, low Apgar scores were more common in preterm females born at 33–37 weeks and vice versa in births over 37 weeks. Conclusion Our data do not support an advantage of either gender in preterm birth of infants who are most likely growth restricted.

scholarly journals Analysis of Hospital Discharge Data to Characterize Obstructive Sleep Apnea and Its Management in Adult Patients Hospitalized in Canada: 2006 to 2007

2010 ◽  
Vol 17 (5) ◽  
pp. 213-218 ◽  
Author(s):  
Kathy F Spurr ◽  
Debra L Morrison ◽  
Michael A Graven ◽  
Adam Webber ◽  
Robert W Gilbert
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hospital Discharge ◽  
Acute Care ◽  
Fiscal Year ◽  
Cpap Therapy ◽  
Discharge Abstract Database ◽  
Discharge Data ◽  
Canadian Institute ◽  
Obstructive Sleep

BACKGROUND: Diagnosed obstructive sleep apnea (OSA) affects 2% to 7% of middle-age persons worldwide and represents a substantial health care burden. The gold standard for treating OSA in adults is continuous positive airway pressure (CPAP) therapy. Compliance with this treatment is especially important in OSA patients experiencing concomitant acute and chronic disease or illness, and those undergoing procedures associated with sedation, analgesia and anesthesia.OBJECTIVE: To describe the clinical characteristics and management of hospitalized OSA patients in Canada.METHODS: Using the Canadian Institute for Health Information’s hospital Discharge Abstract Database (fiscal year 2006/2007), a retrospective cohort study of all acute care patients discharged with a diagnosis that included OSA was performed.RESULTS: An examination of the discharge data of 2,400,245 acute care hospital abstracts identified 8823 cases of OSA. The mean age of OSA patients was 45.7 years and 66.5% were men. The most common comorbidities in the adult OSA population were obesity, cardiovascular disease, type 2 diabetes mellitus and chronic obstructive pulmonary disease. In adult OSA patients, the reported surgical intervention rate using uvulopalatopharyngoplasty (9.6%) was much higher than interventional CPAP therapy (4.8%).CONCLUSIONS: Only a small percentage of hospitalized OSA patients were documented as having received CPAP therapy during their stay. Issues relating to the accuracy, specificity and completeness of the Canadian Institute for Health Information’s hospital Discharge Abstract Database specific to OSA and its management were identified. Practices pertaining to the reporting, coding and management of hospitalized adult OSA patients warrant further investigation and research.

scholarly journals Association of Time–Varying Intensity of Ventilation With Mortality in Patients With COVID−19 ARDS: Secondary Analysis of the PRoVENT–COVID Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Michiel T. U. Schuijt ◽  
David M. P. van Meenen ◽  
Ignacio Martin–Loeches ◽  
Guido Mazzinari ◽  
Marcus J. Schultz ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Secondary Analysis ◽  
Fixed Time ◽  
Sensitivity Analyses ◽  
Cumulative Exposure ◽  
Time Varying ◽  
Joint Models ◽  
Clinical Trial Registration ◽  
Increased Risk ◽  
Different Levels

Background: High intensity of ventilation has an association with mortality in patients with acute respiratory failure. It is uncertain whether similar associations exist in patients with acute respiratory distress syndrome (ARDS) patients due to coronavirus disease 2019 (COVID−19). We investigated the association of exposure to different levels of driving pressure (ΔP) and mechanical power (MP) with mortality in these patients.Methods: PRoVENT–COVID is a national, retrospective observational study, performed at 22 ICUs in the Netherlands, including COVID−19 patients under invasive ventilation for ARDS. Dynamic ΔP and MP were calculated at fixed time points during the first 4 calendar days of ventilation. The primary endpoint was 28–day mortality. To assess the effects of time–varying exposure, Bayesian joint models adjusted for confounders were used.Results: Of 1,122 patients included in the PRoVENT–COVID study, 734 were eligible for this analysis. In the first 28 days, 29.2% of patients died. A significant increase in the hazard of death was found to be associated with each increment in ΔP (HR 1.04, 95% CrI 1.01–1.07) and in MP (HR 1.12, 95% CrI 1.01–1.36). In sensitivity analyses, cumulative exposure to higher levels of ΔP or MP resulted in increased risks for 28–day mortality.Conclusion: Cumulative exposure to higher intensities of ventilation in COVID−19 patients with ARDS have an association with increased risk of 28–day mortality. Limiting exposure to high ΔP or MP has the potential to improve survival in these patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04346342.

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