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@article{Helenius:2019:10.1136/bmj.l5678,
author = {Helenius, K and Longford, N and Lehtonen, L and Modi, N and Gale, C and Babirecki, M and Kamalanathan, A and Wickham, T and Aucharaz, K and Gupta, A and Paul, N and Wong, LM and Mittal, A and Broggio, P and Surana, P and Singh, A and Seal, S and Hassan, A and Schwarz, K and Thomas, M and Foo, A and Anderson, J and Whincup, G and Brearey, S and Chang, J and Gad, K and Hasib, A and Garbash, M and Allwood, A and Adiotomre, P and Brooke, N and Deketelaere, A and Khader, KA and Shephard, R and Rekha, S and Abuzgia, B and Jain, M and Pirie, S and Surana, P and Zengeya, S and Watts, T and Balal, S and Seagrave, C and Bate, T and Dixon, H and Aladangady, N and Gaili, H and James, M and Lal, M and Ambadkar, P and Pandey, P and Hickey, A and Rhodes, S and Pai, V and Lama, M and Miall, L and Cusack, J and Kairamkonda, V and Grosdenier, M and Kollipara, L and Kefas, J and Yoxall, B and Birch, J and Whitehead, G and Krishnamurthy, R and Sashikumar, P and Misra, I and Pillay, T and Ali, I and Thiaga},
doi = {10.1136/bmj.l5678},
journal = {BMJ: British Medical Journal},
pages = {1--11},
title = {Association of early postnatal transfer and birth outside a tertiary hospital with mortality and severe brain injury in extremely preterm infants: observational cohort study with propensity score matching},
url = {http://dx.doi.org/10.1136/bmj.l5678},
volume = {367},
year = {2019}
}

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TY  - JOUR
AB  - Objective To determine if postnatal transfer or birth in a non-tertiary hospital is associated with adverse outcomes.Design Observational cohort study with propensity score matching.Setting National health service neonatal care in England; population data held in the National Neonatal Research Database.Participants Extremely preterm infants born at less than 28 gestational weeks between 2008 and 2015 (n=17 577) grouped based on birth hospital and transfer within 48 hours of birth: upward transfer (non-tertiary to tertiary hospital, n=2158), non-tertiary care (born in non-tertiary hospital; not transferred, n=2668), and controls (born in tertiary hospital; not transferred, n=10 866). Infants were matched on propensity scores and predefined background variables to form subgroups with near identical distributions of confounders. Infants transferred between tertiary hospitals (horizontal transfer) were separately matched to controls in a 1:5 ratio.Main outcome measures Death, severe brain injury, and survival without severe brain injury.Results 2181 infants, 727 from each group (upward transfer, non-tertiary care, and control) were well matched. Compared with controls, infants in the upward transfer group had no significant difference in the odds of death before discharge (odds ratio 1.22, 95% confidence interval 0.92 to 1.61) but significantly higher odds of severe brain injury (2.32, 1.78 to 3.06; number needed to treat (NNT) 8) and significantly lower odds of survival without severe brain injury (0.60, 0.47 to 0.76; NNT 9). Compared with controls, infants in the non-tertiary care group had significantly higher odds of death (1.34, 1.02 to 1.77; NNT 20) but no significant difference in the odds of severe brain injury (0.95, 0.70 to 1.30) or survival without severe brain injury (0.82, 0.64 to 1.05). Compared with infants in the upward transfer group, infants in the non-tertiary care group had no significant difference in death before discharge (1.10, 0.84
AU  - Helenius,K
AU  - Longford,N
AU  - Lehtonen,L
AU  - Modi,N
AU  - Gale,C
AU  - Babirecki,M
AU  - Kamalanathan,A
AU  - Wickham,T
AU  - Aucharaz,K
AU  - Gupta,A
AU  - Paul,N
AU  - Wong,LM
AU  - Mittal,A
AU  - Broggio,P
AU  - Surana,P
AU  - Singh,A
AU  - Seal,S
AU  - Hassan,A
AU  - Schwarz,K
AU  - Thomas,M
AU  - Foo,A
AU  - Anderson,J
AU  - Whincup,G
AU  - Brearey,S
AU  - Chang,J
AU  - Gad,K
AU  - Hasib,A
AU  - Garbash,M
AU  - Allwood,A
AU  - Adiotomre,P
AU  - Brooke,N
AU  - Deketelaere,A
AU  - Khader,KA
AU  - Shephard,R
AU  - Rekha,S
AU  - Abuzgia,B
AU  - Jain,M
AU  - Pirie,S
AU  - Surana,P
AU  - Zengeya,S
AU  - Watts,T
AU  - Balal,S
AU  - Seagrave,C
AU  - Bate,T
AU  - Dixon,H
AU  - Aladangady,N
AU  - Gaili,H
AU  - James,M
AU  - Lal,M
AU  - Ambadkar,P
AU  - Pandey,P
AU  - Hickey,A
AU  - Rhodes,S
AU  - Pai,V
AU  - Lama,M
AU  - Miall,L
AU  - Cusack,J
AU  - Kairamkonda,V
AU  - Grosdenier,M
AU  - Kollipara,L
AU  - Kefas,J
AU  - Yoxall,B
AU  - Birch,J
AU  - Whitehead,G
AU  - Krishnamurthy,R
AU  - Sashikumar,P
AU  - Misra,I
AU  - Pillay,T
AU  - Ali,I
AU  - Thiagarajan,P
AU  - Dyke,M
AU  - Selter,M
AU  - Kamath,P
AU  - Alsford,L
AU  - Spencer,V
AU  - Gupta,S
AU  - Nicholl,R
AU  - Wardle,S
AU  - Chakrabarti,S
AU  - Adams,E
AU  - McDevitt,K
AU  - Reddy,A
AU  - Gibson,D
AU  - Khashu,M
AU  - Reddy,C
AU  - Pearson,F
AU  - Amess,P
AU  - Deshpande,S
AU  - Sleight,E
AU  - Groves,C
AU  - Godambe,S
AU  - Bosman,D
AU  - Rewitzky,G
AU  - Banjoko,O
AU  - Kumar,N
AU  - Muogbo,D
AU  - Lopez,W
AU  - D'Amore,A
AU  - Mattara,S
AU  - Zipitis,C
AU  - De,Halpert P
AU  - Settle,P
AU  - Munyard,P
AU  - McIntyre,J
AU  - Bartle,D
AU  - Pain,K
AU  - Fedee,J
AU  - Maddock,N
AU  - Gupta,R
AU  - Moore,A
AU  - Godden,C
AU  - Amess,P
AU  - Jones,S
AU  - Fenton,A
AU  - Mahadevan,S
AU  - Brown,N
AU  - Mack,K
AU  - Adiotomre,P
AU  - Bolton,R
AU  - Khan,A
AU  - Mannix,P
AU  - Huddy,C
AU  - Yasin,S
AU  - Butterworth,S
AU  - Godambe,S
AU  - Nedungadi,S
AU  - Cairns,P
AU  - Reynolds,P
AU  - Brennan,N
AU  - Heal,C
AU  - Salgia,S
AU  - Abu-Harb,M
AU  - Birch,J
AU  - Knight,C
AU  - Clark,S
AU  - Theron,M
AU  - Murthy,V
AU  - Paul,S
AU  - Kisat,H
AU  - Kendall,G
AU  - Blake,K
AU  - Obi,O
AU  - Garbash,M
AU  - Kumar,H
AU  - Rawlingson,C
AU  - Webb,D
AU  - Bird,S
AU  - Narayanan,S
AU  - Eyre,E
AU  - Evans,I
AU  - Sanghavi,R
AU  - Sullivan,C
AU  - Garr,R
AU  - Leith,W
AU  - Vasu,V
AU  - Harry,L
AU  - Vamvakiti,K
AU  - Vemuri,G
AU  - Eaton,M
AU  - Samy,M
DO  - 10.1136/bmj.l5678
EP  - 11
PY  - 2019///
SN  - 0959-535X
SP  - 1
TI  - Association of early postnatal transfer and birth outside a tertiary hospital with mortality and severe brain injury in extremely preterm infants: observational cohort study with propensity score matching
T2  - BMJ: British Medical Journal
UR  - http://dx.doi.org/10.1136/bmj.l5678
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000492058700004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.bmj.com/content/367/bmj.l5678
UR  - http://hdl.handle.net/10044/1/74709
VL  - 367
ER  -

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