Eileen M. Walsh

Kaiser Permanente

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Michael W. Kuzniewicz

Kaiser Permanente

Gabriel J. Escobar

Kaiser Permanente

Thomas B. Newman

University of California, San Francisco

Sherian X. Li

Kaiser Permanente

Charles E. McCulloch

University of California, San Francisco

Sherian Li

Kaiser Permanente

Tina V. Hartert

Vanderbilt University Medical Center

Pingsheng Wu

Vanderbilt University Medical Center

Tebeb Gebretsadik

Vanderbilt University Medical Center

Valerie J. Flaherman

University of California, San Francisco

Cooperative Institutions

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Research Network (United States)

University of California, San Francisco

Children's Hospital of Philadelphia

RELX Group (Netherlands)

Kaiser Permanente

Pediatrics and Genetics

Harvard University

University of Pennsylvania

Health and Human Development (2HD) Research Network

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Iconography : Prevalence and Neonatal Factors Associated with Autism Spectrum Disorders in Preterm Infants

Michael W. Kuzniewicz Seunghwan Wi Yinge Qian Eileen M. Walsh Mary Anne Armstrong

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Incremental Cost of Prematurity by Week of Gestational Age

American Journal of Perinatology Reports (2019)

Eileen M. Walsh Sherian Li Libby Black Michael W. Kuzniewicz

Objective This study was aimed to compare health care costs and utilization at birth through 1 year, between preterm and term infants, by week of gestation. Methods A cross-sectional study of infants born at ≥ 23 weeks of gestational age (GA) at Kaiser Permanente Northern California facilities between 2000 and 2011, using outcomes data from an internal neonatal registry and cost estimates from an internal cost management database. Adjusted models yielded estimates for cost differences for each GA group. Results Infants born at 25 to 37 weeks incur significantly higher birth hospitalization costs and experience significantly more health care utilization during the initial year of life, increasing progressively for each decreasing week of gestation, when compared with term infants. Among all very preterm infants (≤ 32 weeks), each 1-week decrease in GA is associated with incrementally higher rates of mortality and major morbidities. Conclusion We provide estimates of potential cost savings that could be attributable to interventions that delay or prevent preterm delivery. Cost differences were most extreme at the lower range of gestation (≤ 30 weeks); however, infants born moderately preterm (31–36 weeks) also contribute substantially to the burden, as they represent a higher proportion of total births.

10.1055/s-0039-1683934

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Synchronous CEA and CABG in asymptomatic carotid artery stenosis: A case study

Journal of Vascular Nursing (2019)

Colleen Taylor Eileen M. Walsh Sarah Stamm

Stroke

Endarterectomy

Concomitant

10.1016/j.jvn.2019.03.002

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Citations (1)

Risk of childhood asthma following infant bronchiolitis during the respiratory syncytial virus season

Journal of Allergy and Clinical Immunology (2013)

Kristina James Tebeb Gebretsadik Gabriel J. Escobar Pingsheng Wu Kecia N. Carroll

Pneumovirus

10.1016/j.jaci.2013.01.009

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Citations (78)

FEASIBILITY OF COLLECTING PERIPHERAL BLOOD STEM CELLS (PBSC) IN AN AMBULATORY FACILITY FROM CHILDREN WEIGHING < 25 KG. 915

Pediatric Research (1996)

Sharon L. Gardner Eileen M. Walsh Michael P. LaQuaglia Nicholas C. Saenz Lillian Reich

10.1203/00006450-199604001-00937

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Predicting the Need for Phototherapy After Discharge

PEDIATRICS (2021)

Michael W. Kuzniewicz Ji-Na Park Hamid Niki Eileen M. Walsh Charles E. McCulloch

BACKGROUND AND OBJECTIVES: Bilirubin screening before discharge is performed to identify neonates at risk for future hyperbilirubinemia. The American Academy of Pediatrics recommends using a graph of bilirubin levels by age (the Bhutani Nomogram) to guide follow-up and a different graph to determine phototherapy recommendations. Our objective was to evaluate predictive models that incorporate the difference between the last total serum bilirubin (TSB) before discharge and the American Academy of Pediatrics phototherapy threshold (Δ-TSB) to predict a postdischarge TSB above the phototherapy threshold by using a single graph. METHODS: We studied 148 162 infants born at ≥35 weeks’ gestation at 11 Kaiser Permanente Northern California facilities from 2012 to 2017 whose TSB did not exceed phototherapy levels and who did not receive phototherapy during the birth hospitalization. We compared 3 logistic models (Δ-TSB; Δ-TSB-Plus, which included additional variables; and the Bhutani Nomogram) by using the area under the receiver operating characteristic curve (AUC) in a 20% validation subset. RESULTS: A total of 2623 infants (1.8%) exceeded the phototherapy threshold postdischarge. The predicted probability of exceeding the phototherapy threshold after discharge ranged from 56% for a predischarge Δ-TSB 0 to 1 mg/dL below the threshold to 0.008% for Δ-TSB >7 mg/dL below the threshold. Discrimination was better for the Δ-TSB model (AUC 0.93) and the Δ-TSB-Plus model (AUC 0.95) than for the Bhutani Nomogram (AUC 0.88). CONCLUSIONS: The use of Δ-TSB models had excellent ability to predict postdischarge TSB above phototherapy thresholds and may be simpler to use than the Bhutani Nomogram.

Nomogram

Area under curve

Hospital discharge

10.1542/peds.2020-019778

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Citations (20)

A simplified CD34+ based preharvest prediction tool for HPC(A) collection

Transfusion (2021)

R. Jacob Eileen M. Walsh P. Maslak Sergio Giralt Scott T. Avecilla

Abstract Background Hematopoietic stem cell transplantation is an important treatment that is dependent on the collection of sufficient CD34+ hematopoietic progenitor cells. The peripheral blood CD34 count (PB CD34+ counts) measured by flow cytometry can be used in predicting CD34+ stem cell yields hours before the completion of collection. Previously described formulas to predict the yield have used many different variables. As such, there is currently no consensus on an industry‐standard algorithm or formula. Study Design and Methods Retrospective reviews of same‐day PB CD34+ counts and the ensuing absolute CD34+ yields of mobilized donors (allogeneic and autologous) were used to develop and validate a formula using regression analysis to predict the CD34+ stem cell yield. A metric of prediction correlation, using root mean square error (RMSE), was used to assess the robustness of our prediction formula in addition to comparisons with two other published formulas, as well as subset analysis. Results A formula in the form of y = mx b with r = 0.95 and 95% confidence intervals was generated and validated. The ratio of actual to predicted yield demonstrated a high correlation coefficient (r = 0.96) with linear regression and overall RMSE of 228.4, which was lower than the two prior studies (calculated RMSE = 330.8 and 405.2). Subset analyses indicated male patients, lymphoma patients, and patients >60 years of age demonstrated lower RMSEs. Conclusion We have demonstrated a simple yet robust formula that can be used prospectively to accurately predict the CD34+ stem cell yield in both autologous and allogeneic donors, which also accounts for recipient weight.

10.1111/trf.16356

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Citations (3)

Substance Co-Exposure Among Women With Opioid Use During Pregnancy

Drug and Alcohol Dependence (2024)

Michael W. Kuzniewicz Cynthia I. Campbell Sandra D. Comer Monique M. Hedderson Lisa Croen

10.1016/j.drugalcdep.2023.110238

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Risk of Autism Associated With Hyperbilirubinemia and Phototherapy

PEDIATRICS (2016)

Yvonne W. Wu Michael W. Kuzniewicz Lisa Croen Eileen M. Walsh Charles E. McCulloch

OBJECTIVE: Whether neonatal hyperbilirubinemia and/or phototherapy increase the risk of autism spectrum disorder (ASD) is unclear. We sought to quantify the risk of ASD associated with elevated total serum bilirubin (TSB) levels and with phototherapy. METHODS: In a retrospective cohort study of 525 409 infants born at ≥35 weeks’ gestation in 15 Kaiser Permanente Northern California (KPNC) hospitals, 1995–2011, we obtained all TSB levels and determined which infants received phototherapy. From the KPNC Autism Registry, we identified patients with ASD diagnosed at a KPNC Autism Center, by a clinical specialist, or by a pediatrician. We calculated Cox proportional hazard ratios (HRs) for time to diagnosis of ASD, adjusting for confounding factors. RESULTS: Among infants in the birth cohort, 2% had at least 1 TSB level ≥20 mg/dL, and 8% received phototherapy. The rate of ASD was 13 per 1000 births. Crude analyses revealed an association between TSB ≥20 and ASD (relative risk: 1.4; 95% confidence interval [CI]: 1.1–1.6), and between phototherapy and ASD (relative risk: 1.7; 95% CI: 1.5–1.8). After adjusting for confounders, TSB ≥20 (HR: 1.09; 95% CI: 0.89–1.35) and phototherapy (HR: 1.10; 95% CI: 0.98–1.24) were no longer significantly associated with ASD. Independent risk factors for ASD included maternal and paternal age; maternal and paternal higher education; male sex; birth weight <2500 g or ≥4200 g; and later year of birth. CONCLUSIONS: After adjustment for the effects of sociodemographic factors and birth weight, neither hyperbilirubinemia nor phototherapy was an independent risk factor for ASD.

10.1542/peds.2016-1813

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Citations (25)

Outcomes of Admissions for Preterm Labor

American Journal of Perinatology Reports (2017)

Michael W. Kuzniewicz Libby Black Eileen M. Walsh Sherian Li Mara Greenberg

Objective This study aims to quantitate the incidence of preterm labor (PTL) admissions and determine the frequency and predictors of preterm delivery (PTD) during these admissions. Study Design Retrospective cohort of singleton pregnancies within Kaiser Permanente Northern California, 2001 to 2011. PTL admissions were defined as inpatient encounters > 24 hours with an International Classification of Diseases, 9th Revision code for PTL. Results Total study population was 365,897 with PTL admission rate 11%. PTD occurred in 85% of pregnancies with PTL admission. Delivery occurred within 48 hours of admission in 96% ≥34 weeks, 67% 31 to 33 weeks, and 51.9% <31 weeks. Predictors of delivery during PTL admission included gestational age 34 to 36 weeks (adjusted odds ratio [aOR], 6.90), chorioamnionitis (aOR, 105.58), and preterm rupture of membranes (aOR 19.29). Conclusion We demonstrate a high rate of PTD per PTL admission in a highly integrated health care system. More work is needed to determine optimal practices for hospitalization and treatment of women diagnosed with PTL.

Chorioamnionitis

Singleton

Hospital admission

Diagnosis code

10.1055/s-0037-1603911

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Citations (4)