Menu
×
McClellanville Library
9 a.m. - 1 p.m.
Phone: (843) 887-3699
Folly Beach Library
9 a.m. - 1 p.m.
Phone: (843) 588-2001
Miss Jane's Building (Edisto Library Temporary Location)
9 a.m. – 3 p.m.
Phone: (843) 869-2355
Main Library
Closed (2024 Early Election)
Phone: (843) 805-6930
West Ashley Library
9 a.m. - 4 p.m.
Phone: (843) 766-6635
John L. Dart Library
9 a.m. - 6 p.m.
Phone: (843) 722-7550
St. Paul's/Hollywood Library
Closed (Early Voting)
Phone: (843) 889-3300
Mt. Pleasant Library
9 a.m. – 6 p.m.
Phone: (843) 849-6161
Dorchester Road Library
9 a.m. - 6 p.m.
Phone: (843) 552-6466
Edgar Allan Poe/Sullivan's Island Library
9 a.m. - 6 p.m.
Phone: (843) 883-3914
John's Island Library
9 a.m. - 6 p.m.
Phone: (843) 559-1945
Wando Mount Pleasant Library
9 a.m. - 6 p.m.
Phone: (843) 805-6888
Otranto Road Library
9 a.m. - 6 p.m.
Phone: (843) 572-4094
Hurd/St. Andrews Library
9 a.m. - 6 p.m.
Phone: (843) 766-2546
Baxter-Patrick James Island
9 a.m. - 6 p.m.
Phone: (843) 795-6679
Bees Ferry West Ashley Library
9 a.m. - 6 p.m.
Phone: (843) 805-6892
Village Library
9 a.m. - 6 p.m.
Phone: (843) 884-9741
Keith Summey North Charleston Library
9 a.m. – 6 p.m.
Phone: (843) 744-2489
Mobile Library
9 a.m. - 5 p.m.
Phone: (843) 805-6909
Today's Hours
McClellanville Library
9 a.m. - 1 p.m.
Phone: (843) 887-3699
Folly Beach Library
9 a.m. - 1 p.m.
Phone: (843) 588-2001
Miss Jane's Building (Edisto Library Temporary Location)
9 a.m. – 3 p.m.
Phone: (843) 869-2355
Main Library
Closed (2024 Early Election)
Phone: (843) 805-6930
West Ashley Library
9 a.m. - 4 p.m.
Phone: (843) 766-6635
John L. Dart Library
9 a.m. - 6 p.m.
Phone: (843) 722-7550
St. Paul's/Hollywood Library
Closed (Early Voting)
Phone: (843) 889-3300
Mt. Pleasant Library
9 a.m. – 6 p.m.
Phone: (843) 849-6161
Dorchester Road Library
9 a.m. - 6 p.m.
Phone: (843) 552-6466
Edgar Allan Poe/Sullivan's Island Library
9 a.m. - 6 p.m.
Phone: (843) 883-3914
John's Island Library
9 a.m. - 6 p.m.
Phone: (843) 559-1945
Wando Mount Pleasant Library
9 a.m. - 6 p.m.
Phone: (843) 805-6888
Otranto Road Library
9 a.m. - 6 p.m.
Phone: (843) 572-4094
Hurd/St. Andrews Library
9 a.m. - 6 p.m.
Phone: (843) 766-2546
Baxter-Patrick James Island
9 a.m. - 6 p.m.
Phone: (843) 795-6679
Bees Ferry West Ashley Library
9 a.m. - 6 p.m.
Phone: (843) 805-6892
Village Library
9 a.m. - 6 p.m.
Phone: (843) 884-9741
Keith Summey North Charleston Library
9 a.m. – 6 p.m.
Phone: (843) 744-2489
Mobile Library
9 a.m. - 5 p.m.
Phone: (843) 805-6909
Patron Login
menu
Item request has been placed!
×
Item request cannot be made.
×
Processing Request
Estimated Survival and Major Comorbidities of Very Preterm Infants Discharged Against Medical Advice vs Treated With Intensive Care in China.
Item request has been placed!
×
Item request cannot be made.
×
Processing Request
- Author(s): Jiang S;Jiang S; Huang X; Huang X; Zhang L; Zhang L; Han J; Han J; Yang Y; Yang Y; Wang W; Wang W; Lee SK; Lee SK; Lee SK; Lee SK; Yan W; Yan W; Cao Y; Cao Y
- Source:
JAMA network open [JAMA Netw Open] 2021 Jun 01; Vol. 4 (6), pp. e2113197. Date of Electronic Publication: 2021 Jun 01.- Publication Type:
Comparative Study; Journal Article; Research Support, Non-U.S. Gov't- Language:
English - Source:
- Additional Information
- Corporate Authors:
- Source: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
- Publication Information: Original Publication: Chicago, IL : American Medical Association, [2018]-
- Subject Terms: Mortality* ; Survival Rate*; Infant, Premature, Diseases/*mortality ; Infant, Premature, Diseases/*physiopathology ; Infant, Premature, Diseases/*therapy ; Intensive Care Units, Pediatric/*statistics & numerical data ; Patient Discharge/*statistics & numerical data; China ; Cohort Studies ; Comorbidity ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Male
- Abstract: Importance: A significant proportion of very preterm infants (<32 weeks' gestation) are discharged against medical advice (DAMA) from neonatal intensive care units in China. There is minimal information available on the potential outcomes of providing complete care before discharge in these infants.
Objective: To describe potential neonatal outcomes of DAMA in very preterm infants if they receive complete care based on estimates derived from a group of propensity score-matched infants who are not DAMA.
Design, Setting, and Participants: This cohort study enrolled all infants born at between 24 and 31 weeks' gestation from May 1, 2015, to April 30, 2018, and admitted to 25 tertiary neonatal intensive care units across China within 7 days of birth. A multilevel mixed-effects logistic regression model was constructed to estimate the propensity score for the likelihood of DAMA for each infant. Infants who were not DAMA were then matched to DAMA infants with the closest propensity score on a 1:1 ratio by using a nearest neighbor greedy matching algorithm without replacement. Incidences of neonatal outcomes were then calculated among the matched non-DAMA infants to simulate the outcomes of DAMA infants. Statistical analyses were performed from August 16, 2020, to September 26, 2020.
Exposures: Discharge against medical advice, which was defined as termination of treatment and discharge before the treating physicians recommended discharge.
Main Outcomes and Measures: Survival and survival without major morbidity.
Results: The study enrolled a total of 14 083 infants (8141 boys [57.8%]) with a median gestational age of 30.1 weeks (interquartile range [IQR], 29.0-31.1 weeks) and a median birth weight of 1400 g (IQR, 1170-1600 g). Overall, 1876 of 14 083 very preterm infants (13.3%; 95% CI, 12.8%-13.9%) were DAMA, of whom 1367 of 1876 (72.9%; 95% CI, 70.8%-74.8%) required intensive care on discharge. A total of 1473 DAMA infants were successfully matched to 1473 non-DAMA infants. Overall, 1211 of 1473 matched non-DAMA infants (82.2%; 95% CI, 80.2%-84.1%) survived to discharge. The survival rates were 68.3% (95% CI, 62.4%-73.7%) for infants at 26 to 27 weeks' gestation, 84.1% (95% CI, 80.7%-87.0%) for infants 28 to 29 weeks' gestation, and 92.4% (95% CI, 90.0%-94.2%) for infants at 30 to 31 weeks' gestation. A total of 872 of 1473 matched non-DAMA infants (59.2%; 95% CI, 56.7%-61.7%) survived without any major morbidity.
Conclusions and Relevance: The results of this cohort study suggest that very preterm infants who are DAMA from neonatal intensive care units may have intact survival if complete care is provided. Efforts to reduce DAMA may be associated with improved outcomes of very preterm infants in China. - Comments: Comment in: JAMA Netw Open. 2021 Jun 1;4(6):e2113649. (PMID: 34137833)
- Contributed Indexing: Investigator: Y Cao; S Jiang; Y Ji; S Han; S Wang; Z Li; S Xia; C Yang; C Yang; L Chen; R Shan; L Liu; B Yi; Y Wang; J Liu; L He; M Li; X Pan; Y Guo; C Liu; Q Zhou; X Li; H Xiong; Y Qi; M Hei; Y Han; S Wang; S Li; Z Xia; S Yang; C Lin; Z Chen; L Shan; R Liu; L Yi; B Wang; Y Liu; J He; L Li; M Pan; X Guo; Y Liu; C Zhou; Q Li; X Xiong; H Qi; Y Hei
- Publication Date: Date Created: 20210617 Date Completed: 20220107 Latest Revision: 20220107
- Publication Date: 20240513
- Accession Number: 10.1001/jamanetworkopen.2021.13197
- Accession Number: 34137828
Contact CCPL
Copyright 2022 Charleston County Public Library Powered By EBSCO Stacks 3.3.0 [350.3] | Staff Login
No Comments.