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Objectives <p>Therapeutic hypothermia (TH) improves outcomes in infants ≥36 weeks with HIE, although safety at 35weeks remains uncertain. We compared TH utilization and associated outcomes in 35- versus 36-week infants with HIE.</p> Study design <p>Using the 2016–2022 National Inpatient Sample, we identified 35- and 36-week infants with HIE. The primary outcome was in-hospital mortality; secondary outcomes included coagulopathy and other complications. Logistic regression adjusted for covariates; Cochran–Armitage tested trends in TH use.</p> Results <p>Among 1,397,680 infants, HIE occurred in 2354 (0.48%) at 35 weeks and 3972 (0.44%) at 36 weeks; in-hospital mortality was similar (9.98% vs 9.99%). TH was less frequently used at 35 weeks (19.8% vs 22.4%) but increased over time (<i>p</i> &lt; 0.001). 35-week treated infants had higher unadjusted in-hospital mortality (10.3% vs 6.8%) and coagulopathy (28.7% vs 18.4%); adjusted in-hospital mortality did not differ.</p> Conclusion <p>TH use at 35 weeks is increasing that was not associated with differences in in-hospital mortality. Prospective studies are needed to define its role.</p>

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Therapeutic hypothermia and in-hospital mortality in 35-week infants with encephalopathy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Hany Aly,
  • Hatem Eltaly,
  • Farah A. Mohamed,
  • Firas Saker,
  • Ceyda Acun,
  • Mohamed A. Mohamed

摘要

Objectives

Therapeutic hypothermia (TH) improves outcomes in infants ≥36 weeks with HIE, although safety at 35weeks remains uncertain. We compared TH utilization and associated outcomes in 35- versus 36-week infants with HIE.

Study design

Using the 2016–2022 National Inpatient Sample, we identified 35- and 36-week infants with HIE. The primary outcome was in-hospital mortality; secondary outcomes included coagulopathy and other complications. Logistic regression adjusted for covariates; Cochran–Armitage tested trends in TH use.

Results

Among 1,397,680 infants, HIE occurred in 2354 (0.48%) at 35 weeks and 3972 (0.44%) at 36 weeks; in-hospital mortality was similar (9.98% vs 9.99%). TH was less frequently used at 35 weeks (19.8% vs 22.4%) but increased over time (p < 0.001). 35-week treated infants had higher unadjusted in-hospital mortality (10.3% vs 6.8%) and coagulopathy (28.7% vs 18.4%); adjusted in-hospital mortality did not differ.

Conclusion

TH use at 35 weeks is increasing that was not associated with differences in in-hospital mortality. Prospective studies are needed to define its role.