Evidence map›Paper›PMID 28619775›Full record

ArticleBMJ open2017

Retrospective cohort study of all deaths among infants born between 22 and 27 completed weeks of gestation in Switzerland over a 3-year period.

T M Berger, M A Steurer, H U Bucher, J C Fauchère, M Adams, R E Pfister, R Baumann-Hölzle, D Bassler, Swiss Neonatal End-of-Life Study Group

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

T M BergerNeonatal and Paediatric Intensive Care Unit, Children's Hospital Lucerne, Lucerne, Switzerland.
M A SteurerDivision of Pediatric Critical Care, Department of Pediatrics, University of California Medical Center, San Francisco, California, USA.
H U BucherDepartment of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
J C FauchèreDepartment of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
M AdamsDepartment of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
R E PfisterDivision of Neonatology and Paediatric Intensive Care, Children's University Hospital Geneva, Geneva, Switzerland.
R Baumann-HölzleDialogue Ethics Foundation, Interdisciplinary Institute for Ethics in Health Care, Zurich, Switzerland.
D BasslerDepartment of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Swiss Neonatal End-of-Life Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim of this research is to assess causes and circumstances of deaths in extremely low gestational age neonates (ELGANs) born in Switzerland over a 3-year period.

designPopulation-based, retrospective cohort study.

settingAll nine level III perinatal centres (neonatal intensive care units (NICUs) and affiliated obstetrical services) in Switzerland. PATIENTS: ELGANs with a gestational age (GA) <28 weeks who died between 1 July 2012 and 30 June 2015.

resultsA total of 594 deaths were recorded with 280 (47%) stillbirths and 314 (53%) deaths after live birth. Of the latter, 185 (59%) occurred in the delivery room and 129 (41%) following admission to an NICU. Most liveborn infants dying in the delivery room had a GA ≤24 weeks and died following primary non-intervention. In contrast, NICU deaths occurred following unrestricted life support regardless of GA. End-of-life decision-making and redirection of care were based on medical futility and anticipated poor quality of life in 69% and 28% of patients, respectively. Most infants were extubated before death (87%).

conclusionsIn Switzerland, most deaths among infants born at less than 24 weeks of gestation occurred in the delivery room. In contrast, most deaths of ELGANs with a GA ≥24 weeks were observed following unrestricted provisional intensive care, end-of-life decision-making and redirection of care in the NICU regardless of the degree of immaturity.

Indexed as

Infant, Extremely PrematureAdvance Care PlanningDecision MakingHumansInfantInfant MortalityInfant, NewbornInfant, Premature, DiseasesIntensive Care Units, NeonatalMedical FutilityParentsPractice Guidelines as TopicQuality of LifeRetrospective StudiesSwitzerlandend-of-life decision-makingextremely low gestational age neonateslive birthredirection of carestillbirth

Identifiers

PMID28619775
PMCPMC5734457

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.