Igen kis súlyú vagy 32. gesztációs hétnél éretlenebb koraszülöttek halálozási mutatói Magyarországon a EuroHOPE kutatás tükrében

INTRODUCTION: Care provision for very low birth weight and very low gestational age newborns requires high level clinical preparedness. Appropriate care and care management reduce mortality. AIM: To present Hungarian and international outcomes and local regional differences characterizing neonatal care in 2006-2008, based on the results of the EuroHOPE study. METHOD: Hungarian data were created by linking the obstetrics registry with the financing database of the Health Insurance Fund. Resulting from peculiarities of these databases and clinically justified exclusions, 3562 newborns were included. RESULTS: Hungarian risk-adjusted 365-day mortality rate was significantly higher than in most of the studied countries. Incidence of diseases correlated with higher mortality risk was highest in Hungary. Mortality in two Hungarian counties was worse than expected based on modelling, while it was better in one county. CONCLUSIONS: Systematic factors might cause these results. Relatively low usage rate of steroid prophylaxis in Hungary might contribute to unfavorable mortality figures. A common unique identifier would help database linkage. Orv. Hetil., 2016, 157(41), 1649-1656

Mortality and Length of Stay of Very Low Birth Weight and Very Preterm Infants: A EuroHOPE Study

The objective of this paper was to compare health outcomes and hospital care use of very low birth weight (VLBW), and very preterm (VLGA) infants in seven European countries. Analysis was performed on linkable patient-level registry data from seven European countries between 2006 and 2008 (Finland, Hungary, Italy (the Province of Rome), the Netherlands, Norway, Scotland, and Sweden). Mortality and length of stay (LoS) were adjusted for differences in gestational age (GA), sex, intrauterine growth, Apgar score at five minutes, parity and multiple births. The analysis included 16,087 infants. Both the 30-day and one-year adjusted mortality rates were lowest in the Nordic countries (Finland, Sweden and Norway) and Scotland and highest in Hungary and the Netherlands. For survivors, the adjusted average LoS during the first year of life ranged from 56 days in the Netherlands and Scotland to 81 days in Hungary. There were large differences between European countries in mortality rates and LoS in VLBW and VLGA infants. Substantial data linkage problems were observed in most countries due to inadequate identification procedures at birth, which limit data validity and should be addressed by policy makers across Europe.</p