Estimates of length of neonatal stay for very premature babies in the UK

Manktelow, Bradley N; Draper, Elizabeth S; Field, Christopher R.; Field, David

doi:10.1136/adc.2009.168633

Cited by 38 publications

(43 citation statements)

References 14 publications

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“…An unusual length of stay did not occur in our control group and thus does not explain the reduction in the length of stay we showed associated with OCP. A study of length of stay stratified by birth weight and gestational age in 30 UK NICUs found a median of 48–55 days for 1000–1250 gram infants born at 29 to 30 weeks with or without the need for respiratory support in the first 12 hours of life 21 . Other potential etiologies that might contribute to a difference in length of hospitalization between groups are the age at last significant apneic or bradycardic spell and the age when full oral feeding are achieved.…”

Section: Discussionmentioning

confidence: 99%

Oral colostrum priming shortens hospitalization without changing the immunomicrobial milieu

et al. 2016

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Background Oral colostrum priming (OCP) after birth in preterm infants is associated with improved weight gain and modification of the oral immuno-microbial environment. We hypothesized OCP would modify salivary immune peptides and the oral microbiota in preterm infants. Methods We conducted a prospective, randomized clinical trial to determine the effects of OCP on salivary immune peptide representation in preterm infants (<32 weeks completed gestation at birth). Saliva samples were collected prior to and after OCP. Salivary immune peptide representation was determined via mass spectroscopy. Oral microbiota representation was determined via sequencing of 16S rRNA gene. Results Neonates that received OCP (n = 48) had a 16-day reduction in the median length of hospitalization as compared to infants that did not receive OCP (n = 51). No differences in salivary immune peptide sequence representation prior to OCP between groups were found. Longitudinal changes in peptides were detected (lysozyme C, immunoglobulin A, lactoferrin) but were limited to a single peptide difference (alpha defensin 1) between primed and unprimed infants after OCP. We found no difference in microbial diversity between treatment groups at any time point, but diversity decreased significantly over time in both groups. OCP treatment marginally modified oral taxa with a decline in abundance of Streptococci in the OCP group at 30 days of life. Conclusions OCP had neither an effect on the salivary peptides we examined nor on overall oral bacterial diversity and composition. Infants that received OCP had a reduced length of hospitalization and warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

Oral colostrum priming shortens hospitalization without changing the immunomicrobial milieu

et al. 2016

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“…Several recent studies have reported complex models using detailed information on infant condition and pathophysiology that allow estimation of likely length of stay (and thus date of discharge) for preterm infants. [1][2][3][4] The main purpose of such models has been to allow generic comparison of standards and outcomes of care in different institutions and thus to raise overall standards rather than at the individual level. We report a simple approach to estimation of length of stay for preterm infants that is designed primarily to prepare staff and parents for the baby's discharge rather than to compare practices in different institutions.…”

Section: Introductionmentioning

confidence: 99%

Estimating discharge dates using routinely collected data: improving the preparedness of parents of preterm infants for discharge home

Fleming

Ingram

Johnson

et al. 2016

Arch Dis Child Fetal Neonatal Ed

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The length of stay for moderately preterm infants has progressively become shorter in the UK in recent years but staff still commonly inform parents that their baby will go home around their estimated date of delivery (EDD). Parents need as much notice as possible to prepare for the discharge of their baby, and to gain the necessary skills and knowledge to care for their infant safely. We report the use of routinely collected neonatal data to develop and implement a simple centile chart for date of discharge from hospital, which allows staff and parents to predict the likely discharge date more accurately for preterm infants, most of whom now go home more than 3 weeks before their EDD. This information allows better and timelier planning for discharge of such infants, by parents and staff.

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“…1, 2 While it is inevitable that ELBW infants would have relatively long neonatal intensive care unit (NICU) length of stay (LOS), there may be opportunities for improving and standardizing care, as unexplained variation in LOS has been described for premature infants. 3, 4 Depending on the patient, hospital, and payer, there may be financial considerations that could influence practice in such a manner to discharge such infants sooner or later. 5, 6 For these reasons, after baseline characteristics that contribute meaningful increments in explanatory power are accounted for, LOS may be considered a quality of care measurement.…”

Section: Introductionmentioning

confidence: 99%

“…4 A study of 30 NICUs in the UK included a broad group of premature infants including those 23 to 32 weeks gestation and with birth weight up to 3000 grams. 3 Our aim was to characterize LOS for the smallest, most vulnerable infants who draw especially heavily on NICU resources, across wide levels of hospital care.…”

Section: Introductionmentioning

confidence: 99%

Accounting for variation in length of NICU stay for extremely low birth weight infants

et al. 2013

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ObjectiveTo develop a length of stay (LOS) model for extremely low birth weight (ELBW) infants.Study DesignWe included infants from the California Perinatal Quality Care Collaborative with birth weight 401–1,000 grams who were discharged to home. Exclusion criteria were congenital anomalies, surgery, and death. LOS was defined as days from admission to discharge. As patients who died or were transferred to lower level of care were excluded, we assessed correlation of hospital mortality rates and transfers torisk adjusted LOS.ResultsThere were 2,012 infants with median LOS 79 days (range 23–219). Lower birth weight, lack of antenatal steroids, and lower Apgar score were associated with longer LOS. There was negligiblecorrelation between risk-adjusted LOS and hospital mortality rates (r = 0.0207) and transfer-out rates (r = 0.121).ConclusionParticularly because ELBW infants have extended hospital stays, identification of unbiased and informative risk-adjusted LOS for these infants is an important step in benchmarking best practice and improving efficiency in care.

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Estimates of length of neonatal stay for very premature babies in the UK

Cited by 38 publications

References 14 publications

Oral colostrum priming shortens hospitalization without changing the immunomicrobial milieu

Oral colostrum priming shortens hospitalization without changing the immunomicrobial milieu

Estimating discharge dates using routinely collected data: improving the preparedness of parents of preterm infants for discharge home

Accounting for variation in length of NICU stay for extremely low birth weight infants

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