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Data Elements and MethodologyThe data included within these pages of the website are the result of a focused query that explored the incidence and outcomes of various diagnoses within hospitals using the Neonatal Information System™. The data is categorized by items such as admitting disposition, birthweight, delivery type, APGAR scores, and gestational age. The patient population is based on all patients admitted within the first five days of life, discharged, transferred, or expired during the corresponding calendar year, and cared for in an intensive care or special care unit during part of their hospital stay (healthy newborns have been excluded from this population). Query Data Elements
Fifty institutions participated in this study representing over 22,000 neonatal intensive care admissions per year. MethodologyPopulationWhen establishing guidelines for patients to accept as part of this study group, the following criteria was chosen: Patients must have:
Relational CategoriesAs you will see, the layout of the booklet portrays information in graphs and tables. The graphs and tables are broken out on the basis of birthweight, and gestational age. The birthweight and gestational age categories were defined as: Birthweight
Gestational Age
For a few of the tables and charts, the birthweight category has been abbreviated and is labeled by a single number which is the top of the birthweight category. Thus, "1499" represents the weight class "1000 to 1499 grams." Length of Stay DefinitionLength of Stay represents the patient's total number in a NICU or Special Care Unit. Discharge StatusThe term discharged refers to discharged to home, transferred refers to transferred to either another unit within the hospital or to another institution. Multiple AdmissionsIn the fairly unusual event that the patient has had multiple admissions, we chose to link these admissions if the initial status was transferred. In the event of multiple admissions we include days in special care from all admissions in the length of stay calculations. Total ventilatory and respiratory support days are calculated in a similar manner. If one of the queried diagnoses was present in either admission, it would count as a single incidence of that diagnosis. The status of the patient would be the status of the last admission. Ventilatory SupportVentilatory support is defined as mechanical ventilation. This would include such things as ventilator, jet ventilator, ECMO, or oscillator. It would exclude CPAP and oxygen hood. The charts on the course of ventilatory support depict the status for the group of patients with a birthweight less than 1500 gms and on ventilatory support within 2 days of admission. The patients status is shown for hospital days 3, 7, 14, 28 and final status. The four possible status states are expired, discharged/transferred, on ventilatory support and off ventilatory support. Respiratory SupportRespiratory support includes all types of oxygen support. DiagnosesFor IVH and ROP, only Grades III and above are included. All other diagnoses are defined by each individual institution. Late Onset Sepsis is defined as a confirmed sepsis identified on hospital day seven or later. Incidences of Sepsis per 1000 Patient Days is the number of separate sepsis incidences (could be more than one incidence per patient) per 1000 NICU/Special Care patient days. 25th and 75th PercentilesTo give an indication of the dispersion of the individual hospital results, we have indicated the 25th and 75th percentile on each chart. That is, 25 percent of the hospitals fell below this 25th percentile point and 25 percent of the hospitals exceeded the 75th percentile point. Standardized RateWhere appropriate a standardized rate is calculated. This figure is simply the institution's result weighted by the percentage of neonates found in the National Neonatal Database weight categories. This figures yields a composite rate normalized for differences between the institution and national distribution of percentage of admissions in each birthweight category. MiscellaneousHere are some other terms used throughout these pages:
The distribution of hospitals and patients by NICU level is as follows:
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Data Elements 
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