Inter-NICU variation in rates and management of thrombocytopenia among very low birth-weight infants

Doron J. Kahn, Douglas K. Richardson, Henny H. Billett

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objectives: To investigate variation among neonatal intensive care units (NICUs) in prevalence and management of thrombocytopenia in infants <1500 g. Study Design: In total 1283 infants <1500 g admitted to six NICUs over 21 months were prospectively analyzed. Illness severity was measured by the Score for Neonatal Acute Physiology (SNAP). Platelet counts in the first 12 hours after birth and on day 3 of life were abstracted from the infants' medical records. Thrombocytopenia was determined from the lowest platelet count in each of these time periods. Results: There was variability in rates of thrombocytopenia among NICUs, even after controlling for risk factors (e.g., SNAP, small for gestational (SGA) age and maternal hypertension). One site had a high prevalence of thrombocytopenia, but the lowest percentage of infants with thrombocytopenia who received platelet transfusions. After controlling for SNAP, GA, SGA, Apgar score and incidence of thrombocytopenia, the odds of receiving platelets at this site, relative to the site with the highest transfusion rate, was 0.10 (95% CI 0.02 to 0.43). Conclusions: This multicenter study finds a 10-fold variation among NICU in the administration of platelets to their thrombocytopenic infants that cannot be explained by presence of thrombocytopenia or illness severity.

Original languageEnglish (US)
Pages (from-to)312-316
Number of pages5
JournalJournal of Perinatology
Volume23
Issue number4
DOIs
StatePublished - Jun 2003

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Very Low Birth Weight Infant
Neonatal Intensive Care Units
Thrombocytopenia
Platelet Count
Blood Platelets
Surrogate Mothers
Platelet Transfusion
Apgar Score
Gestational Age
Multicenter Studies
Medical Records
Parturition
Hypertension
Incidence

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Inter-NICU variation in rates and management of thrombocytopenia among very low birth-weight infants. / Kahn, Doron J.; Richardson, Douglas K.; Billett, Henny H.

In: Journal of Perinatology, Vol. 23, No. 4, 06.2003, p. 312-316.

Research output: Contribution to journalArticle

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