{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:58:29Z","timestamp":1789981109517,"version":"4.0.1"},"reference-count":19,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,7,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>To examine factors affecting center differences in mortality for extremely low birth weight (ELBW) infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We analyzed data for 5418 ELBW infants born at 16 Neonatal Research Network centers during 2006\u20132009. The primary outcomes of early mortality (\u226412 hours after birth) and in-hospital mortality were assessed by using multilevel hierarchical models. Models were developed to investigate associations of center rates of selected interventions with mortality while adjusting for patient-level risk factors. These analyses were performed for all gestational ages (GAs) and separately for GAs &amp;lt;25 weeks and \u226525 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Early and in-hospital mortality rates among centers were 5% to 36% and 11% to 53% for all GAs, 13% to 73% and 28% to 90% for GAs &amp;lt;25 weeks, and 1% to 11% and 7% to 26% for GAs \u226525 weeks, respectively. Center intervention rates significantly predicted both early and in-hospital mortality for infants &amp;lt;25 weeks. For infants \u226525 weeks, intervention rates did not predict mortality. The variance in mortality among centers was significant for all GAs and outcomes. Center use of interventions and patient risk factors explained some but not all of the center variation in mortality rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Center intervention rates explain a portion of the center variation in mortality, especially for infants born at &amp;lt;25 weeks\u2019 GA. This finding suggests that deaths may be prevented by standardizing care for very early GA infants. However, differences in patient characteristics and center intervention rates do not account for all of the observed variability in mortality; and for infants with GA \u226525 weeks these differences account for only a small part of the variation in mortality.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2012-3707","type":"journal-article","created":{"date-parts":[[2013,6,11]],"date-time":"2013-06-11T04:04:46Z","timestamp":1370923486000},"page":"e175-e184","source":"Crossref","is-referenced-by-count":60,"title":["Individual and Center-Level Factors Affecting Mortality Among Extremely Low Birth Weight Infants"],"prefix":"10.1542","volume":"132","author":[{"given":"Brandon W.","family":"Alleman","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Iowa, Iowa City, Iowa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Iowa, Iowa City, Iowa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Statistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Dagle","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Iowa, Iowa City, Iowa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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Michael","family":"Cotten","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetha","family":"Shankaran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wayne State University, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele C.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Rainbow Babies and Children\u2019s Hospital, Case Western Reserve University, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbot R.","family":"Laptook","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan 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