556 - Impact of 24 hour In-house Neonatologist coverage on short-term outcomes in preterm infants < 27 weeks GA

Publication Number: 556.5476

EMAN HASHIM, University of Toronto Temerty Faculty of Medicine, TORONTO, ON, Canada; Anusha N. Shah, Mount Sinai Hospital, Brampton, ON, Canada; ARYA R. SHAH, Mount Sinai, Mississauga, ON, Canada; Rebecca P. Pillai Riddell, Dr. Rebecca Pillai Riddell, Toronto, ON, Canada; Karel O'Brien, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; EMER FINAN, Sinai Health System, Toronto, ON, Canada; Vibhuti Shah, Mount Sinai Hospital, Toronto, ON, Canada

Background: Implementation of 24 hour (h) in-house neonatologist coverage has been driven by its reported association with improved patient outcomes. However, the available evidence is inconsistent with some studies suggesting reduced mortality while others report no significant difference in patient outcomes. A model of 24 h neonatologist coverage was introduced at Mount Sinai Hospital from July 1st, 2020.

Objective: To evaluate the impact of 24 h neonatologist coverage on short-term neonatal outcomes of preterm infants < 27 weeks GA.

Design/Methods: Retrospective cohort study of preterm infants < 27 weeks during 2 time periods: Pre-implementation phase July 1st, 2019 to June 30th, 2020) and Post-implementation phase (July 1st, 2020 to June 30th, 2021) were included. Infants who were offered palliative care, infants with major congenital anomalies, those who died or were transferred to another hospital prior to a cranial ultrasound being performed and those who were out born were excluded. Maternal and neonatal baseline characteristics and outcomes data were collected from electronic medical records and from the Canadian Neonatal Network (CNN). Data were compared using χ2 test for categorical data and t-test or Wilcoxon rank test for continuous data. Statistical analyses was conducted using R software with significance level of P < 0.05.

Results: A total of 176 infants were included. Maternal and neonatal baseline and management characteristics are presented in Table 1. There were no statistically significant differences noted between the 2 phases. Similarly, no statistically significant differences were noted in the short-term outcomes between the 2 phases (Table 2).

Conclusion(s): 24 h neonatologist coverage had no impact on short-term neonatal outcomes at our center. Potential reasons for our findings include the availability of an experienced inter-professional team and standardized management guidelines for initial stabilization and care.

Table 1: Maternal and neonatal baseline and management characteristics
PAS-TABLE1.jpeg*Results are presented as mean (SD), median (IQR), number (%) as appropriate

Table 2: Short-term neonatal outcomes
PAS-TABLE2.jpegResults are presented as number (%)