Using benchmarking to identify inter-centre differences in persistent ductus arteriosus treatment: can we improve outcome?

Esther J.S. Jansen, Koen P. Dijkman, Richard A. van Lingen, Willem B. de Vries, Daniel C. Vijlbrief, Willem P. de Boode (Corresponding author), Peter Andriessen

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)

Abstract

Objective The aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes. Materials and methods We carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure. Results In total, 367 preterm infants were included. All four participating neonatal ICU had a comparable number of preterm infants; however, differences were observed in the incidence of treatment (33-63%), choice and dosing of medication (ibuprofen or indomethacin), number of pharmacological courses (1-4), and the need for surgical ligation after failure of pharmacological treatment (8-52%). Despite the differences in treatment, we found no difference in short-term morbidity between the centres. Adjusted mortality showed independent risk contribution of gestational age, birth weight, ductal ligation, and perinatal centre. Conclusions Using benchmarking as a tool identified inter-centre differences. In these four perinatal centres, the factors that explained the differences in patent ductus arteriosus treatment are quite complex. Timing, choice of medication, and dosing are probably important determinants for successful patent ductus arteriosus closure.

Original languageEnglish
Pages (from-to)1488-1496
Number of pages9
JournalCardiology in the Young
Volume27
Issue number8
DOIs
Publication statusPublished - 1 Oct 2017
Externally publishedYes

Keywords

  • Patent ductus arteriosus
  • ibuprofen
  • indomethacin
  • ductal ligation
  • newborn
  • patent ductus arteriosus

Impacts

Perinatal Medicine

M.B. (Beatrijs) van der Hout-van der Jagt (Content manager)

Impact: Research Topic/Theme (at group level)

Cite this