Practice variation in anti-epileptic drug use for neonatal hypoxic-ischemic encephalopathy among regional NICUs

BMC Pediatrics
Maria L V DizonAn N Massaro

Abstract

While intercenter variation (ICV) in anti-epileptic drug (AED) use in neonates with seizures has been previously reported, variation in AED practices across regional NICUs has not been specifically and systematically evaluated. This is important as these centers typically have multidisciplinary neonatal neurocritical care teams and protocolized approaches to treating conditions such as hypoxic ischemic encephalopathy (HIE), a population at high risk for neonatal seizures. To identify opportunities for quality improvement (QI), we evaluated ICV in AED utilization for neonates with HIE treated with therapeutic hypothermia (TH) across regional NICUs in the US. Children's Hospital Neonatal Database and Pediatric Health Information Systems data were linked for 1658 neonates ≥36 weeks' gestation, > 1800 g birthweight, with HIE treated with TH, from 20 NICUs, between 2010 and 2016. ICV in AED use was evaluated using a mixed-effect regression model. Rates of AED exposure, duration, prescription at discharge and standardized AED costs per patient were calculated as different measures of utilization. Ninety-five percent (range: 83-100%) of patients with electrographic seizures, and 26% (0-81%) without electrographic seizures, received AE...Continue Reading

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Citations

Oct 28, 2020·International Journal of Molecular Sciences·Aida Menéndez MéndezTobias Engel
Aug 14, 2021·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Julie M ZiobroRenée A Shellhaas

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Methods Mentioned

BETA
sedation

Clinical Trials Mentioned

NCT01720667

Software Mentioned

TOBY
CHND
CoolCap
SAS

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