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Table 3 Pre- and post-workshop comparisons of neonatal clinical outcomes

From: The effect of professional-led guideline workshops on clinical practice for the management of patent ductus arteriosus in preterm neonates in Japan: a controlled before-and-after study

 

Intervention NICUs (N= 2)

Control NICUs (N= 88)

Intervention vs. control group difference

Outcomes

Pre-WS n = 146 (%)

Post-WS n = 148 (%)

Unadjusted OR (95% CI)

Adjusted OR (95% CI)

Pre-WS n = 3,322 (%)

Post-WS n = 2,912 (%)

Unadjusted OR (95% CI)

Adjusted OR (95% CI)

DID in post- vs. pre-WS (95% CI)**

Mortality

15 (10.3)

5 (3.4)

0.31 (0.11, 0.86)*

0.30 (0.1, 0.89)*

207 (6.2)

147 (5.1)

0.80 (0.64, 0.99)*

0.75 (0.59, 0.95)*

−5.71 (−11.6, 0.12)

RDS

80 (54.8)

90 (60.8)

1.28 (0.81,2.04)

1.55 (0.90, 2.68)

1,893/3,322 (57.0)

1,682/,2884 (58.3)

1.06 (0.96, 1.17)

1.05 (0.93, 1.18)

4.68 (−6.86, 16.2)

BPD

25/141 (17.7)

36/147 (24.5)

1.51 (0.85, 2.67)

1.66 (0.90, 3.07)

490/3,282 (14.9)

504/2,858 (17.6)

1.22 (1.07,1.40)*

1.23 (1.06, 1.44)*

4.05 (−5.51, 13.6)

Severe IVH

6 (4.1)

8 (5.4)

1.33 (0.45, 3.94)

1.38 (0.45, 4.27)

145/3,322 (4.4)

126/2,882 (4.4)

1.00 (0.78, 1.28)

1.0 (0.77, 1.30)

1.29 (−3.68, 6.26)

PVL

3/146 (2.1)

6/143 (4.2)

2.09 (0.51, 8.51)

2.09 (0.51, 8.51)

112/3,318 (3.4)

91/2,864 (3.2)

0.94 (0.71, 1.24)

1.0 (0.75, 1.34)

2.34 (−1.77, 6.45)

ROP

14/139 (10.1)

17/140 (12.1)

1.23 (0.58, 2.61)

1.50 (0.66, 3.41)

289/2,429 (11.9)

360/2,512 (14.3)

1.23 (1.05, 1.46)*

1.33 (1.11, 1.60)*

0.36 (−7.97, 7.24)

NEC

3 (2.1)

3 (2.0)

0.98 (0.19, 4.97)

1.11 (0.22, 5.72)

55/3,322 (1.7)

53/2,889 (1.8)

1.11 (0.76, 1.62)

1.01 (0.68, 1.51)

−0.21 (−3.5, 3.09)

Early sepsis

3 (2.1)

2 (1.4)

0.65 (0.11, 3.97)

0.65 (0.11, 3.97)

88 (2.6)

92 (3.2)

1.20 (0.89, 1.61)

1.27 (0.94,1.73)

−1.21 (−4.29, 1.86)

Late sepsis

7 (4.8)

6 (4.1)

0.84 (0.27, 2.56)

0.93 (0.30, 2.91)

168/3,313 (5.1)

172/2,880 (6.0)

1.19 (0.95, 1.48)

1.17 (0.93, 1.48)

−1.64 (−6.48, 3.20)

PDA

47 (32.2)

45 (30.4)

0.92 (0.56, 1.51)

0.97 (0.57, 1.65)

1,286/3,322 (38.7)

1,109/2,884 (38.5)

0.99 (0.89, 1.10)

0.95 (0.85, 1.07)

−1.53 (−12.4, 9.35)

Indomethacin

43 (29.5)

44 (29.7)

1.01 (0.61, 1.67)

1.01 (0.64, 1.86)

1,229 (37.0)

1,054 (36.2)

0.97 (0.87, 1.07)

0.93 (0.83, 1.05)

1.08 (−9.63, 11.8)

PDA ligation

13 (8.9)

7 (4.7)

0.51 (0.20, 1.31)

0.46 (0.17, 1.23)

208/3,322 (6.3)

185/2,865 (6.5)

1.03 (0.84, 1.27)

0.96 (0.77, 1.20)

−4.37 (−10.3, 1.51)

Air leak

7 (4.8)

4 (2.7)

0.55 (0.16, 1.93)

0.66 (0.17, 2.22)

88/3,322 (2.7)

93/2,880 (3.2)

1.23 (0.91, 1.65)

1.22 (0.90, 1.66)

−2.67 (−7.09, 1.75)

PPHN

11 (7.5)

15 (10.1)

1.38 (0.61, 3.12)

1.33 (0.57, 3.17)

132/3,322 (4.0)

152/2,872 (5.3)

1.35 (1.06, 1.71)*

1.39 (1.09,1.79)*

1.28 (−5.28, 7.85)

  1. Variables with missing data are indicated by the denominators showing the numbers of the assessed neonates. Covariates included in the multiple logistic regression models were gender, gestational age, Apgar score < 7 at 5 minutes, cesarean section, antenatal steroids use, maternal hypertension, chorioamnionitis, and outborn.
  2. Pre-WS: before the workshops; Post-WS: after the workshops. OR odds ratio, 95% CI 95% confidence interval, RDS respiratory distress syndrome, BPD bronchopulmonary dysplasia, IVH intraventricular hemorrhage, PVL periventricular leukomalacia, ROP retinopathy of prematurity, NEC necrotizing enterocolitis, PDA patent ductus arteriosus, PPHN persistent pulmonary hypertension.
  3. *Statistically significant at the 5% probability level; **DID: The difference in differences of neonatal outcomes (percentage points) = differences (%) between the post- and pre-WS for the intervention NICUs − differences (%) between the post- and pre-WS for the control NICUs, estimated using a probit model.