Inter-center variation in autopsy practices among regional neonatal intensive care units (NICUs)

• DOI: 10.1038/s41372-021-01286-1
• Publication Date: 2022-01-04T11:04:48Z
• Authors: Ankur Datta; Jason Z. Niehaus; Julie Weiner; Isabella Zaniletti; Nana Matoba; Kevin M. Sullivan; Robert DiGeronimo; Carl H. Coghill; Girija Natarajan; Steven R. Leuthner; Amy Brown Schlegel; Anita Shah; Karna Murthy; ; Jessica T. Fry
• Keywords: Demographics

To characterize infants who underwent autopsy in regional neonatal intensive care units (NICUs) and examine inter-center variability in autopsy completion.Retrospective cohort study of infants who died between 2010 and 2016 from 32 participating hospitals in the Children's Hospital Neonatal Database (CHND). Maternal/infant demographics and hospital stay data were collected, along with autopsy rates by center, year, and region. Data analysis utilized bivariate and multivariable statistics.Of 6299 deaths, 1742 (27.7%) completed autopsy. Infants who underwent autopsy had higher median birth weight (2 124 g vs. 1 655 g) and gestational age (34 vs. 32 weeks). No differences were seen in sex, length of stay, or primary cause of death. Marked inter-center variability was observed, with 17-fold adjusted difference (p < 0.001) in autopsy rates.Patient characteristics do not account for variability in autopsy practices across regional NICUs. Factors such as provider practices and parental preferences should be investigated.