Neonatology

Shrunken Risk-Adjusted Rates

The Department of Neonatology has 87 beds with level IV and level III capacities serving Main Campus , Fairview, and Hillcrest hospitals. In addition, we have active labor and delivery services taking care of more than 9000 deliveries. The Vermont Oxford Network (VON), with its data repository for neonatal outcomes, provides a benchmark for neonatal outcome across the country.

Shrunken Risk-Adjusted Data at Cleveland Clinic Children's Level IV NICU

2015 - 2017

Cleveland Clinic Children’s level IV Neonatal Intensive Care Unit ( NICU ) at Main Campus is highly specialized and supported with a special delivery unit that handles deliveries complicated by maternal congenital heart diseases or prenatally diagnosed fetal anomalies. Our unit has Neuro-Intensive Care with whole body hypothermia, highly specialized neonatal surgeries, ECMO, Cardiac Intensive Care Unit, and fetal care center.

The results from Cleveland Clinic Children’s NICU compare very favorably with the Vermont Oxford Network Expanded Infants Database. Despite the high acuity and complexity of the patient population, risk-adjusted data continue to improve compared with previous years. Evaluating data on a yearly basis helps identify opportunities for continued improvement.

Lower 95% Confidence Interval Cleveland Clinic Children's Upper 95% Confidence Interval
Mortality 0.7 1.0 1.4
Late Bacterial Infection 0.5 1.0 1.6
NEC 0.4 0.5 1.1
Pneumothorax 0.4 0.7 1.0
BPD 0.6 0.9 1.3
CONS 0.1 0.4 1.0
Shrunken Risk-Adjusted Data at Cleveland Clinic Children's Level III NICUs

2015 - 2017

The combined Hillcrest and Fairview 2015-2017 risk-adjusted data for mortality, bronchopulmonary dysplasia, necrotizing enterocolitis, Severe IVH, advanced retinopathy of prematurity, and periventricular leukomalacia for very low birth weight infants are presented. Late-onset bacterial infections are also presented. A new project utilizing minimal invasive respiratory support "Bubble C-PAP" was established at Fairview in 2018 and was recently initiated at Hillcrest to make an impact on BPD. Preliminary data from Fairview are already showing a significant impact (10.6 % compared to 30% at the VON network).

Lower 95% Confidence Interval CCF Upper 95% Confidence Interval
Mortality 0.4 0.7 1.0
Late Bacterial Infection 0.2 0.4 0.7
NEC 0.4 0.8 1.3
BPD 0.8 1.1 1.5
Severe IVH 0.6 0.8 1.2
PVL 0.1 0.5 1.0
Advanced ROP 0.5 1.0 1.5
Fungal Infection 0.0 0.3 1.7

BPD = bronchopulmonary dysplasia, CONS = coagulase-negative staphylococci, IVH = intraventricular hemmorage, NEC = necrotizing enterocolitis, NICU = Neonatal Intensive Care Unit, PVL = periventricular leukomalacia, ROP = retinopathy of prematurity

References

Vermont Oxford Network Expanded Infants Database