scholarly journals Analysis of an overlapping surgery policy change on costs in a high-volume neurosurgical department

2019 ◽  
Vol 131 (3) ◽  
pp. 903-910 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea A. Brock ◽  
William T. Couldwell ◽  
John R. W. Kestle ◽  
...  
Keyword(s):  
Policy Change ◽  
Linear Regression Analysis ◽  
Hospital Costs ◽  
Medical Community ◽  
Neurosurgical Procedures ◽  
Multivariate Linear Regression Analysis ◽  
Neurosurgical Department ◽  
Total Hospital ◽  
Entire Cohort ◽  
Significant Difference

OBJECTIVEOverlapping surgery remains a controversial topic in the medical community. Although numerous studies have examined the safety profile of overlapping operations, there are few data on its financial impact. The authors assessed direct hospital costs associated with neurosurgical operations during periods before and after a more stringent overlapping surgery policy was implemented.METHODSThe authors retrospectively reviewed the records of nonemergency neurosurgical operations that took place during the periods from June 1, 2014, to October 31, 2014 (pre–policy change), and from June 1, 2016, to October 31, 2016 (post–policy change), by any of the 4 senior neurosurgeons authorized to perform overlapping cases during both periods. Cost data as well as demographic, surgical, and hospitalization-related variables were obtained from an institutional tool, the Value-Driven Outcomes database.RESULTSA total of 625 hospitalizations met inclusion criteria for cost analysis; of these, 362 occurred prior to the policy change and 263 occurred after the change. All costs were reported as a proportion of the average total hospitalization cost for the entire cohort. There was no significant difference in mean total hospital costs between the prechange and postchange period (0.994 ± 1.237 vs 1.009 ± 0.994, p = 0.873). On multivariate linear regression analysis, neither the policy change (p = 0.582) nor the use of overlapping surgery (p = 0.273) was significantly associated with higher total hospital costs.CONCLUSIONSA more restrictive overlapping surgery policy was not associated with a reduction in the direct costs of hospitalization for neurosurgical procedures.

109 Impact of a More Restrictive Overlapping Surgery Policy An Analysis of Complication Rates, Resident Involvement, and Surgical Wait Times at a High-Volume Neurosurgical Department

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 222-222 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea Archambault Brock ◽  
William T Couldwell ◽  
John R Kestle ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Policy Change ◽  
Preoperative Evaluation ◽  
Linear Regression Analysis ◽  
Medical Community ◽  
Wait Times ◽  
Neurosurgical Procedures ◽  
Complication Rates ◽  
Resident Involvement ◽  
The Impact

Abstract INTRODUCTION Recently, overlapping surgery has been a source of controversy both in the popular press and within the academic medical community. There have been no studies examining the possible effects of more stringent overlapping surgery restrictions. The authors examined the impact of a new overlapping surgery policy on complication rates, neurosurgical resident education, and wait times for neurosurgical procedures. METHODS The authors performed a retrospective chart review of nonemergent neurosurgical procedures performed over two periods from June 1, 2014, to October 31, 2014 (pre-policy change) and from June 1, 2016, to October 31, 2016 (post-policy change) by any of 4 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases. Information on preoperative evaluation, patient demographics, premorbid conditions, surgical variables, and postoperative course were collected and analyzed. RESULTS >Six hundred fifty-three patients met inclusion criteria for complications analysis. Of these, 378 (57.9%) underwent surgery before the policy change. On multivariable regression analysis, neither overlapping surgery (OR 1.072, 95% CI 0.710-1.620) nor the overlapping surgery policy change (1.057, OR 0.700 1.596) was associated with overall complication rates. Similarly, neither overlapping surgery (OR 1.472, 95% CI 0.883 2.454) nor the overlapping surgery policy change (OR 1.251, 95% CI 0.748 2.091) was associated with numbers of serious complications. After the policy change, the percentage of procedures in which the senior assistant was a post-residency fellow increased significantly, from 11.9% to 34.2% (P< 0.001). In a multiple linear regression analysis of surgery wait time, patients undergoing surgery post-policy change had significantly longer delays from the decision to operate to the actual neurosurgical procedure (P< 0.001). CONCLUSION At our institution, further restriction of overlapping surgery was not associated with a reduction in overall or serious complications. Resident involvement in neurosurgical procedures decreased significantly after the policy change, and our study suggests that waiting times for neurosurgical procedures also significantly lengthened.

scholarly journals Impact of a more restrictive overlapping surgery policy: an analysis of pre- and postimplementation complication rates, resident involvement, and surgical wait times at a high-volume neurosurgical department

2018 ◽  
Vol 129 (2) ◽  
pp. 515-523 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea A. Brock ◽  
William T. Couldwell ◽  
John R. W. Kestle ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Policy Change ◽  
Linear Regression Analysis ◽  
Medical Community ◽  
Wait Times ◽  
Neurosurgical Procedures ◽  
Complication Rates ◽  
First Case ◽  
Resident Involvement ◽  
The Impact

OBJECTIVERecently, overlapping surgery has been a source of controversy both in the popular press and within the academic medical community. There have been no studies examining the possible effects of more stringent overlapping surgery restrictions. At the authors’ institution, a new policy was implemented that restricts attending surgeons from starting a second case until all critical portions of the first case that could require the attending surgeon’s involvement are completed. The authors examined the impact of this policy on complication rates, neurosurgical resident education, and wait times for neurosurgical procedures.METHODSThe authors performed a retrospective chart review of nonemergency neurosurgical procedures performed over two periods—from June 1, 2014, to October 31, 2014 (pre–policy change) and from June 1, 2016, to October 31, 2016 (post–policy change)—by any of 4 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases. Information on preoperative evaluation, patient demographics, premorbid conditions, surgical variables, and postoperative course were collected and analyzed.RESULTSSix hundred fifty-three patients met inclusion criteria for complications analysis. Of these, 378 (57.9%) underwent surgery before the policy change. On multivariable regression analysis, neither overlapping surgery (odds ratio [OR] 1.072, 95% confidence interval [CI] 0.710–1.620) nor the overlapping surgery policy change (OR 1.057, 95% CI 0.700–1.596) was associated with overall complication rates. Similarly, neither overlapping surgery (OR 1.472, 95% CI 0.883–2.454) nor the overlapping surgery policy change (OR 1.251, 95% CI 0.748–2.091) was associated with numbers of serious complications. After the policy change, the percentage of procedures in which the senior assistant was a postresidency fellow increased significantly, from 11.9% to 34.2% (p < 0.001). In a multiple linear regression analysis of surgery wait times, patients undergoing surgery after the policy change had significantly longer delays from the decision to operate until the actual neurosurgical procedure (p < 0.001).CONCLUSIONSAt the authors’ institution, further restriction of overlapping surgery was not associated with a reduction in overall or serious complications. Resident involvement in neurosurgical procedures decreased significantly after the policy change, and this study suggests that wait times for neurosurgical procedures also significantly lengthened.

scholarly journals Effect of Surgical Setting on Hospital-Reported Outcomes for Elective Lumbar Spinal Procedures: Tertiary Versus Community Hospitals

2019 ◽  
Vol 10 (4) ◽  
pp. 375-383 ◽  
Author(s):  
Tristan B. Weir ◽  
Neil Sardesai ◽  
Julio J. Jauregui ◽  
Ehsan Jazini ◽  
Michael J. Sokolow ◽  
...  
Keyword(s):  
Pay For Performance ◽  
Linear Regression Analysis ◽  
Degenerative Spondylolisthesis ◽  
Hospital Costs ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
Community Hospitals ◽  
Single Level ◽  
Significant Difference ◽  
Reported Data

Study Design: Retrospective cohort study. Objective: As hospital compensation becomes increasingly dependent on pay-for-performance and bundled payment compensation models, hospitals seek to reduce costs and increase quality. To our knowledge, no reported data compare these measures between hospital settings for elective lumbar procedures. The study compares hospital-reported outcomes and costs for elective lumbar procedures performed at a tertiary hospital (TH) versus community hospitals (CH) within a single health care system. Methods: Retrospective review of a physician-maintained, prospectively collected database consisting of 1 TH and 4 CH for 3 common lumbar surgeries from 2015 to 2016. Patients undergoing primary elective microdiscectomy for disc herniation, laminectomy for spinal stenosis, and laminectomy with fusion for degenerative spondylolisthesis were included. Patients were excluded for traumatic, infectious, or malignant pathology. Comparing hospital settings, outcomes included length of stay (LOS), rates of 30-day readmissions, potentially preventable complications (PPC), and discharge to rehabilitation facility, and hospital costs. Results: A total of 892 patients (n = 217 microdiscectomies, n = 302 laminectomies, and n = 373 laminectomy fusions) were included. The TH served a younger patient population with fewer comorbid conditions and a higher proportion of African Americans. The TH performed more decompressions ( P < .001) per level fused; the CH performed more interbody fusions ( P = .007). Cost of performing microdiscectomy ( P < .001) and laminectomy ( P = .014) was significantly higher at the TH, but there was no significant difference for laminectomy with fusion. In a multivariable stepwise linear regression analysis, the TH was significantly more expensive for single-level microdiscectomy ( P < .001) and laminectomy with single-level fusion ( P < .001), but trended toward significance for laminectomy without fusion ( P = .052). No difference existed for PPC or readmissions rate. Patients undergoing laminectomy without fusion were discharged to a facility more often at the TH ( P = .019). Conclusions: We provide hospital-reported outcomes between a TH and CH. Significant differences in patient characteristics and surgical practices exist between surgical settings. Despite minimal differences in hospital-reported outcomes, the TH was significantly more expensive.

scholarly journals Prospective Comparative Study of Preoperative Expectations and Postoperative Outcomes in Anatomic and Reverse Shoulder Arthroplasty

Joints ◽  
2021 ◽  
Author(s):  
Cassandra Lawrence ◽  
Mark Lazarus ◽  
Joseph Abboud ◽  
Gerald Williams ◽  
Surena Namdari
Keyword(s):  
Shoulder Arthroplasty ◽  
Functional Outcomes ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Linear Regression Analysis ◽  
Postoperative Outcomes ◽  
Consecutive Series ◽  
Multivariate Linear Regression Analysis ◽  
Significant Difference ◽  
Preoperative Expectations

Abstract Background Compared with anatomic total shoulder arthroplasty (aTSA), reverse total shoulder arthroplasty (RTSA) is associated with lower preoperative and postoperative outcome scores and range of motion. It is unknown whether patients' preoperative expectations of surgery are lower in RTSA compared with aTSA. The purpose of this study was to assess preoperative patient expectations and postoperative outcomes in aTSA and RTSA. Methods A consecutive series of patients undergoing primary aTSA for diagnosis of osteoarthritis or primary RTSA for diagnosis of rotator cuff tear arthropathy were studied prospectively. Expectations were evaluated using the validated Hospital for Special Surgery's Shoulder Surgery Expectations Survey. Baseline demographics, comorbidities, and social factors were collected. Baseline and 2 years postoperative American Shoulder and Elbow Surgeons (ASES) score, visual analog scale pain, Single Assessment Number Evaluation (SANE), and patient satisfaction were obtained. Results There were 128 patients (64 aTSA and 64 RTSA). There was no significant difference in total preoperative expectations score between groups. On multivariate linear regression analysis, aTSA (p = 0.024) and younger age (p = 0.018) were associated with higher expectations for improved ability to exercise. Changes in preoperative to postoperative ASES (p = 0.004) and SANE (p = 0.001) scores were higher in the aTSA group. Total preoperative expectations score was not correlated with postoperative functional outcomes or satisfaction in either group. In the aTSA group, expectations for participation in exercise were positively correlated with changes in preoperative to postoperative ASES score (p = 0.01) and SANE score (p = 0.01). Conclusion Though patients undergoing primary aTSA demonstrated greater improvement in functional outcome than those undergoing primary RTSA, both groups reported similar aggregate preoperative expectations. Those undergoing aTSA had higher expectations for return to exercise which was positively correlated with postoperative functional outcomes. Level of Evidence Level II, prospective cohort study.

scholarly journals Leptin’s concentration in tears and dry eye: a clinical observational study

2021 ◽  
Vol 14 (1) ◽  
pp. 83-88
Author(s):  
Ran Hao ◽  
◽  
Xue-Min Li ◽  
Keyword(s):  
Dry Eye ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Ocular Surface Disease Index ◽  
Fluorescein Staining ◽  
Significant Difference ◽  
Eye Symptoms ◽  
Tear Meniscus Height ◽  
Symptoms And Signs ◽  
Dry Eye Symptoms

AIM: To investigate the concentration of leptin in tears and its correlation with dry eye symptoms and signs. METHODS: The study enrolled individuals (n=39) responding to an advertising or dry eye patients (n=58) from the Ophthalmology Department. Tear samples were collected for leptin concentration measuring. Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), tear break up time (TBUT), cornea fluorescein staining, Schirmer test (ST) and impression cytology (IC) were assessed. Leptin concentration in tears of dry eye patients and healthy controls, and its correlation with clinical features of dry eye disease (DED) were analyzed. RESULTS: Age, body mass index (BMI), OSDI scores and cornea fluorescein staining scores showed a negative correlation with leptin concentration in tears (r=-0.340, P=0.001; r=-0.332, P=0.001; r=-0.258, P=0.011; r=-0.424, P<0.001, respectively). ST showed positive correlation with leptin concentration in tears (r=0.206, P=0.045). No significant difference was observed in leptin concentration between dry eye patients and controls (P=0.682). Multivariate linear regression analysis revealed that dry eye, OSDI, corneal fluorescein staining scores and ST correlated with leptin concentration in tears. CONCLUSION: This is the first study measuring leptin concentration in tears. The correlation between leptin concentration and DED symptoms and signs reveal that leptin level correlated with the dry eye, potentially contributing to repair of ocular damage and dry eye improvement.

scholarly journals Does Indoor Daylight Level Affect Hospital Costs and Length of Stay of Patients? A Retrospective Cohort Study

2021 ◽  
Author(s):  
Xiawei Li ◽  
Jianyao Lou ◽  
Aiguang Shi ◽  
Ning Wang ◽  
Lin Zhou ◽  
...  
Keyword(s):  
Length Of Stay ◽  
General Surgery ◽  
Hospital Costs ◽  
Design Guidelines ◽  
Environmental Benefits ◽  
Psychological State ◽  
Total Hospital ◽  
Light Levels ◽  
Large Patient ◽  
Significant Difference

Abstract BackgroundIndoor daylight levels can directly affect people’s physical and psychological state. However, the effect of indoor daylight levels on patient’s clinical recovery process remains controversial. To evaluate the effect of indoor daylight levels on hospital costs and average length of stay (LOS) of a large patient population in general surgery wards.MethodsData were collected retrospectively and analysed of patients in the Second Affiliated Hospital of Zhejiang University, School of Medicine between January 2015 and August 2020. We measured light levels in the patient rooms of general surgery and assessed their association with patients’ total hospital costs and LOS.ResultsA total of 2,998 patients were included in this study with 1,478 each assigned to two light level groups after matching. Overall comparison of hospital total costs and LOS among patients according to light levels did not show a significant difference. Subgroup analysis showed when exposed to higher intensity of indoor daylight, illiterate patients had lower total hospital costs and shorter LOS as compared to those exposed to lower intensity.ConclusionsIndoor daylight levels were not associated with the hospital costs and LOS of patients in the wards of general surgery, except for those who were illiterate. It might be essential to design guidelines for medical staff and healthcare facilities to enhance indoor environmental benefits of daylight for some specific population.

Abstract 1122‐000065: Hospital Cost of DTAS Compared to ED Transfers for LVOs Undergoing Mechanical Thrombectomy

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Joshua S Catapano ◽  
Andrew Ducruet ◽  
Felipe Albuquerque ◽  
Ashutosh Jadhav
Keyword(s):  
Hospital Cost ◽  
Mechanical Thrombectomy ◽  
Linear Regression Analysis ◽  
Index Patient ◽  
Stent Retriever ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Access Site ◽  
Angiography Suite ◽  
Significant Difference

Introduction : Direct‐to‐angiography‐suite (DTAS) transfer for patients with large vessel occlusions (LVOs) undergoing mechanical thrombectomy is associated with decreased workflow times and improved neurological outcomes. Herein, we sought to demonstrate a decrease in hospital cost associated with DTAS compared to emergency department (ED) transfers for patient undergoing mechanical thrombectomy for an LVO. Methods : A retrospective analysis was performed on all patients who underwent mechanical thrombectomy for an LVO at a single comprehensive stroke center between January 1st, 2017, and March 31st, 2021. All patients who were either transferred DTAS or ED were included and compared. Total hospital cost (sum of overhead, professional, diagnostic, and room charges throughout the entire index patient admission) was obtained from the hospital financial department for the index treatment admission. A propensity adjusted (matched for age, sex, vessel occluded, co‐morbidities, BMI, admission NIHSS, access site, and use of a stent retriever) was implemented. Mean difference in hospital cost following adjustment was the primary outcome. Results : During the study period, 341 patients underwent mechanical thrombectomy for an LVO. Of these patients, 140 (41%) were transferred DTAS and 96 (28%) to the ED. There were no significant differences between cohorts in terms of age, sex, vessel occluded, admission NIHSS, co‐morbidities, number of passes, TICI score, access site, stent retriever, major complications, or in‐hospital mortality. The DTAS cohort ($33,061, sD $17,258) had a significantly lower hospital cost compared to ED transferred patients ($38,030, sD $18,572) (p = 0.04). There was no significant difference between the ED (12.2, sD 11.8) and DTAS (11.6, sD 11.1) cohorts in discharge NIHSS. Following propensity score adjustment, linear regression analysis found DTAS (compared to ED transfer) to be significantly associated with a decrease in hospital cost ($‐6,344; 95% CI: $‐11,067 to $‐1,623; p = 0.009). Conclusions : DTAS transfer for patients undergoing an acute mechanical thrombectomy for a LVO was associated with a greater than $6,000 decrease total hospital cost compared to patients first transferred to the ED. The present study further supports DTAS transfer for patients undergoing mechanical thrombectomy for LVO.

scholarly journals Single-Port Laparoscopic Surgery Is Feasible and Safe for Hepatic Left Lateral Sectionectomy for Benign Liver Lesions

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Yuan Cheng ◽  
Ze-sheng Jiang ◽  
Xiao-ping Xu ◽  
Wen-fa Huang ◽  
Guo-lin He ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Pain Score ◽  
Single Port ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Left Hepatic Lobe ◽  
Left Lateral Sectionectomy ◽  
Hepatic Lobe ◽  
Significant Difference ◽  
Lateral Sectionectomy

Background and Objectives. The feasibility and safety of single-port laparoscopic surgery for left lateral liver lobectomy are largely unknown. This study is aimed at comparing the effectiveness and safety between single-port laparoscopic (SPL) and conventional multiport laparoscopic (CL) surgeries for hepatic left lateral sectionectomy. Methods. A total of 65 patients receiving laparoscopic hepatic left lateral sectionectomy between January 2008 and July 2015 were included and divided into the SPL group (n=40) and the CL group (n=25). Results. There was no significant difference in the operative time, estimated intraoperative blood loss, length of hospital stay, and incidences of postoperative complications (biliary leakage, hemorrhage, and contusion at incision) between groups (all P>0.05). However, the SPL group had a significantly lower VAS pain score (at 24 h but not 7 days postoperation) and higher cosmetic satisfaction scores (at both 2 months and 6 months postoperation) than the CL group (all P<0.01). Moreover, multivariate linear regression analysis further confirmed the superior pain score and cosmetic outcome in the SPL group. Conclusions. Single-port laparoscopic hepatic left lateral sectionectomy is a safe and feasible treatment for patients with lesions in the left hepatic lobe. Patients with benign lesions in the left hepatic lobe are more suitable to receive single-port laparoscopic hepatic left lateral sectionectomy than those with malignancies.

scholarly journals Big Data-Enabled Analysis of DRGs-Based Payment on Stroke Patients in Jiaozuo, China

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Dawei Qiao ◽  
Yanru Zhang ◽  
Ateeq ur Rehman ◽  
Mohammad R. Khosravi
Keyword(s):  
Big Data ◽  
Linear Regression ◽  
Influence Factor ◽  
Linear Regression Analysis ◽  
Hospital Costs ◽  
Influence Factors ◽  
Henan Province ◽  
Analysis Tool ◽  
Multivariate Linear Regression Analysis ◽  
Stroke Patients

Stroke is the first leading cause of mortality in China with annual 2 million deaths. According to the National Health Commission of the People’s Republic of China, the annual in-hospital costs for the stroke patients in China reach ¥20.71 billion. Moreover, multivariate stepwise linear regression is a prevalent big data analysis tool employing the statistical significance to determine the explanatory variables. In light of this fact, this paper aims to analyze the pertinent influence factors of diagnosis related groups- (DRGs-) based stroke patients on the in-hospital costs in Jiaozuo city of Henan province, China, to provide the theoretical guidance for medical payment and medical resource allocation in Jiaozuo city of Henan province, China. All medical data records of 3,590 stroke patients were from the First Affiliated Hospital of Henan Polytechnic University between 1 January 2019 and 31 December 2019, which is a Class A tertiary comprehensive hospital in Jiaozuo city. By using the classical statistical and multivariate linear regression analysis of big data related algorithms, this study is conducted to investigate the influence factors of the stroke patients on in-hospital costs, such as age, gender, length of stay (LoS), and outcomes. The essential findings of this paper are shown as follows: (1) age, LoS, and outcomes have significant effects on the in-hospital costs of stroke patients; (2) gender is not a statistically significant influence factor on the in-hospital costs of the stroke patients; (3) DRGs classification of the stroke patients manifests not only a reduced mean LoS but also a peculiar shape of the distribution of LoS.

scholarly journals Analysis of T-786C and 4a/b endothelial nitric oxide synthase gene polymorphisms in retinopathy of prematurity

Genetika ◽  
2016 ◽  
Vol 48 (2) ◽  
pp. 707-716 ◽  
Author(s):  
Jelica Pantelic ◽  
Tatjana Varljen ◽  
Nela Maksimovic ◽  
Biljana Jekic ◽  
Ana Oros ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Gene Polymorphisms ◽  
Linear Regression Analysis ◽  
Control Group ◽  
Enos Gene ◽  
Multivariate Linear Regression Analysis ◽  
Significant Difference

Retinopathy of prematurity (ROP) is a vascular proliferative disorder of retina, that causes visual impairment in premature children. Beside well known risk factors such as short gestational age, low birth weight and early oxygen exposure, genetic susceptibility is considered as a risk factor for development of the disease. The aim of our study was to explore the association of T-786C and 4a/b eNOS gene polymorphisms with the development of severe ROP. Study included 174 preterm infants, 84 with ROP and 90 as a control group. No differences have been observed in genotypes and alleles distributions of eNOS T-786C and eNOS 4a/b polymorphisms between two analyzed groups. There was significant difference in female infants by dominant model for 4a/b genotypes (4bb/4ba+4aa). Namely, female infants in ROP group were more frequently carriers of 4ba and 4aa genotypes than female infants in control group (p=0.037). Analysis of association between 4a/b eNOS polymorphism and ROP among preterm infants have not shown statistically significant association (p=0.288). Gestational age values by recessive model (4bb+4ba/4aa) were significantly lower in infants with 4aa genotype (t=2.034 p=0.044). Almost all detected 4aa genotypes were present in the group of infants with gestational age under 30 weeks (p=0.032), but multivariate linear regression analysis does not show association of 4a/b genotypes with gestational age of premature infants. According to results of the present study T-786C and 4a/b polymorphisms of the eNOS gene may not be the risk factors for the manifestation of severe ROP in Serbian infants.

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