{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T23:24:48Z","timestamp":1793489088528,"version":"4.5.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>\n            Objective\u2003Diagnosis-related groups (DRGs) are used to summarize hospital morbidity and mortality. Each DRG has a weight which is important in calculating the case mix index (CMI), a numeric summary of disease complexity in a population of patients. We utilized DRG weight and resultant CMI to compare postnatal outcomes among singletons versus monochorionic and monoamniotic, monochorionic diamniotic, and dichorionic diamniotic twins.<\/jats:p><jats:p>\n            Study Design\u2003This single-center and retrospective cohort study evaluated DRGs assigned by the investigators, birth weight, gestational age, length of stay (LOS), NICU admission rate, and mortality in twin births between 2014 and 2016. Twins were analyzed depending on chorionicity and amnionicity. Overall, 3 months of singleton births served as the control. The CMI derived from DRG weights were compared across groups.<\/jats:p><jats:p>\n            Results\u2003Twins (n\u2009=\u2009288) had lower gestational ages and birth weights and higher mortality, LOS, NICU admission rates and DRG weights\/CMI compared with singletons (n\u2009=\u2009327; p\u2009&lt;\u20090.001 for each). The LOS was no different between twin subtypes; monochorionic monoamniotic twins had the highest mortality and DRG weight (p\u2009&lt;\u20090.001).<\/jats:p><jats:p>\n            Conclusion\u2003DRG weight and CMI values summarize in-hospital complexity and can be a useful tool to evaluate differences in care complexity among groups of patients.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1721847","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T23:53:56Z","timestamp":1609372436000},"page":"1223-1228","source":"Crossref","is-referenced-by-count":13,"title":["Diagnosis-Related Group Weight and Derived Case Mix Index to Assess the Complexity among Twins"],"prefix":"10.1055","volume":"39","author":[{"given":"Rikizam M.","family":"Joya","sequence":"additional","affiliation":[{"name":"Departments of Neonatology and Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Cottrell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Autumn","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Departments of Neonatology and Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Polak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, West Virginia University School of Medicine, Morgantown, West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"key":"ref1","first-page":"iii, 1\u201353","article-title":"Case mix definition by diagnosis-related groups","volume":"18","author":"R B Fetter","year":"1980","journal-title":"Med Care"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"e183235","DOI":"10.1001\/jamanetworkopen.2018.3235","article-title":"Association of antenatal steroid exposure with survival among infants receiving postnatal life support at 22 to 25 weeks' gestation","volume":"1","author":"D EY Ehret","year":"2018","journal-title":"JAMA Netw Open"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"e1502","DOI":"10.1542\/peds.2012-3435","article-title":"Temporal trends in survival among infants with critical congenital heart defects","volume":"131","author":"M E Oster","year":"2013","journal-title":"Pediatr"},{"key":"ref5","volume-title":"Births in the United States, 2015. National vital statistics reports; vol 66 no 1","author":"J A Martin","year":"2015"},{"issue":"06","key":"ref6","first-page":"1","article-title":"Centers for disease prevention (CDC)","volume":"66","author":"S Sunderam","year":"2017","journal-title":"MMWR Surveill Summ"},{"key":"ref7","volume-title":"Three decades of twin births in the United States, 1980\u20132009","author":"J A Martin","year":"2012"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1001\/jamapediatrics.2014.1357","article-title":"Hospital costs of multiple-birth and singleton-birth children during the first 5 years of life and the role of assisted reproductive technology","volume":"168","author":"G M Chambers","year":"2014","journal-title":"JAMA Pediatr"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1002\/uog.10057","article-title":"Influence of chorionicity on perinatal outcome in a large cohort of Danish twin pregnancies","volume":"39","author":"A Oldenburg","year":"2012","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"16","key":"ref10","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1056\/NEJMoa073059","article-title":"Intensive care for extreme prematurity--moving beyond gestational age","volume":"358","author":"J E Tyson","year":"2008","journal-title":"N Engl J Med"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1542\/peds.2015-2336","article-title":"Committee on Fetus and Newborn. Clinical report - antenatal counseling regarding resuscitation and intensive care before 25 weeks of gestation","volume":"136","author":"J Cummings","year":"2015","journal-title":"Pediatrics"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1111\/j.1471-0528.1997.tb10948.x","article-title":"The hidden mortality of monochorionic twin pregnancies","volume":"104","author":"N J Sebire","year":"1997","journal-title":"Br J Obstet Gynaecol"},{"issue":"07","key":"ref13","first-page":"595","article-title":"Effects of placental chorionicity on outcome in twin pregnancies. A cohort study","volume":"44","author":"H Minakami","year":"1999","journal-title":"J Reprod Med"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1055\/s-2001-12937","article-title":"Adverse perinatal outcome of twin pregnancies according to chorionicity: review of the literature","volume":"18","author":"D M Sherer","year":"2001","journal-title":"Am J Perinatol"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.ijgo.2006.11.002","article-title":"Twin chorionicity and the risk of adverse perinatal outcome","volume":"96","author":"R Acosta-Rojas","year":"2007","journal-title":"Int J Gynaecol Obstet"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/j.1471-0528.2007.01556.x","article-title":"Increased perinatal mortality and morbidity in monochorionic versus dichorionic twin pregnancies: clinical implications of a large Dutch cohort study","volume":"115","author":"K E Hack","year":"2008","journal-title":"BJOG"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1097\/00005373-199810000-00032","article-title":"The ICD-9-based illness severity score: a new model that outperforms both DRG and APR-DRG as predictors of survival and resource utilization","volume":"45","author":"R Rutledge","year":"1998","journal-title":"J Trauma"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00005650-199501000-00001","article-title":"Predicting inpatient costs with admitting clinical data","volume":"33","author":"W M Tierney","year":"1995","journal-title":"Med Care"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1721847.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,27]],"date-time":"2022-08-27T22:41:47Z","timestamp":1661640107000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1721847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,30]]},"references-count":17,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,8,27]]},"published-print":{"date-parts":[[2022,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1721847","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,30]]}}}