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The Turkish Neonatal Jaundice Online Registry: A national root cause analysis

BACKGROUND: Neonatal jaundice (NNJ) is common, but few root cause analyses based on national quality registries have been performed. An online registry was established to estimate the incidence of NNJ in Turkey and to facilitate a root cause analysis of NNJ and its complications. METHODS: A multicen...

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Autores principales: Erdeve, Omer, Okulu, Emel, Olukman, Ozgur, Ulubas, Dilek, Buyukkale, Gokhan, Narter, Fatma, Tunc, Gaffari, Atasay, Begum, Gultekin, Nazli Dilay, Arsan, Saadet, Koc, Esin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825038/
https://www.ncbi.nlm.nih.gov/pubmed/29474382
http://dx.doi.org/10.1371/journal.pone.0193108
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author Erdeve, Omer
Okulu, Emel
Olukman, Ozgur
Ulubas, Dilek
Buyukkale, Gokhan
Narter, Fatma
Tunc, Gaffari
Atasay, Begum
Gultekin, Nazli Dilay
Arsan, Saadet
Koc, Esin
author_facet Erdeve, Omer
Okulu, Emel
Olukman, Ozgur
Ulubas, Dilek
Buyukkale, Gokhan
Narter, Fatma
Tunc, Gaffari
Atasay, Begum
Gultekin, Nazli Dilay
Arsan, Saadet
Koc, Esin
author_sort Erdeve, Omer
collection PubMed
description BACKGROUND: Neonatal jaundice (NNJ) is common, but few root cause analyses based on national quality registries have been performed. An online registry was established to estimate the incidence of NNJ in Turkey and to facilitate a root cause analysis of NNJ and its complications. METHODS: A multicenter prospective study was conducted on otherwise healthy newborns born at ≥35 weeks of gestation and hospitalized for only NNJ in 50 collaborator neonatal intensive care units across Turkey over a 1-year period. Patients were analyzed for their demographic and clinical characteristics, treatment options, and complications. RESULTS: Of the 5,620 patients enrolled, 361 (6.4%) had a bilirubin level ≥25 mg/dL on admission and 13 (0.23%) developed acute bilirubin encephalopathy. The leading cause of hospital admission was hemolytic jaundice, followed by dehydration related to a lack of proper feeding. Although all infants received phototherapy, 302 infants (5.4%) received intravenous immunoglobulin in addition to phototherapy and 132 (2.3%) required exchange transfusion. The infants who received exchange transfusion were more likely to experience hemolytic causes (60.6% vs. 28.1%) and a longer duration of phototherapy (58.5 ± 31.7 vs. 29.4 ± 18.8 h) compared to infants who were not transfused (p < 0.001). The incidence of short-term complications among discharged patients during follow-up was 8.5%; rehospitalization was the most frequent (58%), followed by jaundice for more than 2 weeks (39%), neurological abnormality (0.35%), and hearing loss (0.2%). CONCLUSIONS: Severe NNJ and bilirubin encephalopathy are still problems in Turkey. Means of identifying at-risk newborns before discharge during routine postnatal care, such as bilirubin monitoring, blood group analysis, and lactation consultations, would reduce the frequency of short- and long-term complications of severe NNJ.
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spelling pubmed-58250382018-03-19 The Turkish Neonatal Jaundice Online Registry: A national root cause analysis Erdeve, Omer Okulu, Emel Olukman, Ozgur Ulubas, Dilek Buyukkale, Gokhan Narter, Fatma Tunc, Gaffari Atasay, Begum Gultekin, Nazli Dilay Arsan, Saadet Koc, Esin PLoS One Research Article BACKGROUND: Neonatal jaundice (NNJ) is common, but few root cause analyses based on national quality registries have been performed. An online registry was established to estimate the incidence of NNJ in Turkey and to facilitate a root cause analysis of NNJ and its complications. METHODS: A multicenter prospective study was conducted on otherwise healthy newborns born at ≥35 weeks of gestation and hospitalized for only NNJ in 50 collaborator neonatal intensive care units across Turkey over a 1-year period. Patients were analyzed for their demographic and clinical characteristics, treatment options, and complications. RESULTS: Of the 5,620 patients enrolled, 361 (6.4%) had a bilirubin level ≥25 mg/dL on admission and 13 (0.23%) developed acute bilirubin encephalopathy. The leading cause of hospital admission was hemolytic jaundice, followed by dehydration related to a lack of proper feeding. Although all infants received phototherapy, 302 infants (5.4%) received intravenous immunoglobulin in addition to phototherapy and 132 (2.3%) required exchange transfusion. The infants who received exchange transfusion were more likely to experience hemolytic causes (60.6% vs. 28.1%) and a longer duration of phototherapy (58.5 ± 31.7 vs. 29.4 ± 18.8 h) compared to infants who were not transfused (p < 0.001). The incidence of short-term complications among discharged patients during follow-up was 8.5%; rehospitalization was the most frequent (58%), followed by jaundice for more than 2 weeks (39%), neurological abnormality (0.35%), and hearing loss (0.2%). CONCLUSIONS: Severe NNJ and bilirubin encephalopathy are still problems in Turkey. Means of identifying at-risk newborns before discharge during routine postnatal care, such as bilirubin monitoring, blood group analysis, and lactation consultations, would reduce the frequency of short- and long-term complications of severe NNJ. Public Library of Science 2018-02-23 /pmc/articles/PMC5825038/ /pubmed/29474382 http://dx.doi.org/10.1371/journal.pone.0193108 Text en © 2018 Erdeve et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Erdeve, Omer
Okulu, Emel
Olukman, Ozgur
Ulubas, Dilek
Buyukkale, Gokhan
Narter, Fatma
Tunc, Gaffari
Atasay, Begum
Gultekin, Nazli Dilay
Arsan, Saadet
Koc, Esin
The Turkish Neonatal Jaundice Online Registry: A national root cause analysis
title The Turkish Neonatal Jaundice Online Registry: A national root cause analysis
title_full The Turkish Neonatal Jaundice Online Registry: A national root cause analysis
title_fullStr The Turkish Neonatal Jaundice Online Registry: A national root cause analysis
title_full_unstemmed The Turkish Neonatal Jaundice Online Registry: A national root cause analysis
title_short The Turkish Neonatal Jaundice Online Registry: A national root cause analysis
title_sort turkish neonatal jaundice online registry: a national root cause analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825038/
https://www.ncbi.nlm.nih.gov/pubmed/29474382
http://dx.doi.org/10.1371/journal.pone.0193108
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