Does Duration Off Respiratory Support Prior to Discharge from NICU Predict Hospital Readmission among Extremely Low Gestational Age Neonates?

Abstract

Objective Our objective was to determine if the duration off respiratory support prior to discharge home from the neonatal intensive care unit (NICU) would impact hospital readmission rates among extremely low gestational age neonates (ELGAN). Study Design In this retrospective chart review, we examined readmission rates for ELGAN admitted to the Montefiore–Weiler NICU between 2013 and 2015. Results Of 140 infants born at <29 weeks' gestational age, 30 (21%) of these infants were subsequently readmitted within 90 days, primarily for respiratory complaints. Readmitted infants were born at an earlier gestational age (median = 26 weeks; interquartile range [IQR]: 24–27 weeks) compared to infants who did not require readmission (median = 27 weeks; IQR: 25-28 weeks), p = 0.03. Birth weights were smaller among infants who required readmission, 800 ± 248 g compared to 910 ± 214 g (p = 0.02). Infants with Hispanic ethnicity and those discharged during the spring season were likely to be readmitted. Duration off respiratory support prior to discharge did not predict 90-day readmission rates. Lower gestational age and birth weight were associated with higher rates of readmissions after NICU discharge. Conclusion Duration off and invasiveness of respiratory support prior to discharge did not predict risk of 90-day readmission nor did discharge during months with traditionally higher prevalence of respiratory viruses.

Risk factors and prediction score model for unplanned readmission among neonates with NRDS under one year of age: A retrospective cohort study

“…Nitric oxide inhalation for 24 h at least, n p = 0.012) and BW (1.7 ± 0.5 kg, p = 0.007), which is consistent with the findings of Pattnaik et al (29). However, in the multivariate analysis, therapeutic treatments were predictive of readmission than these demographic characteristics.…”

“…NRDS is still an important disease affecting infants in neonatal intensive care units (1-3), and even after being successfully cured and discharged, some infants with NRDS may still be at high risk for readmission due to lung problems in the first year of life. The results of our study showed that the unplanned readmission rate was 22% in NRDS infants who received follow-up, which was similar to the extremely low-GA neonates reported before (21%) (29). Our study confirmed that the most common risk factors for readmission in neonates with NRDS were postnatal DEX administration, and HOT, which were very different from previous studies in adults with RDS (12-14), whose readmission was mainly for infection, gastrointestinal, and cardiovascular reasons.…”

“…Infants born at lower BW and earlier GA were at a higher risk of readmission (29). In our study, the infants who were more likely to be readmitted had lower birth GA (31.9 weeks,…”

“…Infants born at lower BW and earlier GA were at a higher risk of readmission ( 29 ). In our study, the infants who were more likely to be readmitted had lower birth GA (31.9 weeks, p = 0.012) and BW (1.7 ± 0.5 kg, p = 0.007), which is consistent with the findings of Pattnaik et al ( 29 ). However, in the multivariate analysis, therapeutic treatments were predictive of readmission than these demographic characteristics.…”