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Using benchmarking to identify inter-centre differences in persistent ductus arteriosus treatment: can we improve
Esther J S Jansen1, Koen P Dijkman1, Richard A van Lingen2
11Department of Neonatology,Máxima Medical Centre,Veldhoven,The Netherlands.
Cardiology in the Young
|April 13, 2017
Summary
Inter-centre variations in treating persistent ductus arteriosus (PDA) in preterm infants were identified. Treatment strategies varied significantly, but short-term morbidity did not differ, though mortality was linked to factors like gestational age and ductal ligation.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Clinical Outcomes Research
Background:
- Persistent ductus arteriosus (PDA) is common in preterm infants.
- Variations in PDA treatment protocols exist across neonatal intensive care units (NICUs).
Purpose of the Study:
- To identify and analyze inter-centre differences in the treatment of PDA.
- To investigate the relationship between treatment variations and patient outcomes.
Main Methods:
- Retrospective, multicentre study of preterm infants (24-27 weeks gestation) from 2010-2011.
- Echocardiography used for PDA diagnosis and closure documentation.
- Analysis of treatment incidence, medication choice/dosing, and surgical ligation rates.
Main Results:
- Significant variations observed in PDA treatment incidence (33-63%), medication use, and surgical ligation rates (8-52%).
- No significant differences in short-term morbidity were found between centres.
- Adjusted mortality was independently associated with gestational age, birth weight, ductal ligation, and perinatal centre.
Conclusions:
- Benchmarking revealed substantial inter-centre differences in PDA management.
- Factors influencing PDA treatment success are complex, likely involving timing, medication choice, and dosage.
- Standardization of PDA treatment may be warranted to optimize outcomes.