Morbidities and Hospital Resource Use During the First 3 Years of Life Among Very Preterm Infants

Korvenranta, Emmi; Lehtonen, Liisa; Peltola, Mikko; Häkkinen, Unto; Andersson, Sture; Gissler, Mika; Hallman, Mikko; Leipälä, Jaana; Rautava, Liisi; Tammela, Outi; Linna, Miika

doi:10.1542/peds.2008-1378

Cited by 34 publications

(32 citation statements)

References 25 publications

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“…[1][2][3][4][5] These rehospitalizations are accompanied by significant morbidity and sometimes mortality 4,5 and occur at high cost to the family as well as society. 4,6 Strategies such as the use of prophylaxis for respiratory syncytial virus infections 7 and comprehensive follow-up care 8 are designed to reduce these rehospitalizations.…”

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confidence: 99%

Identification of Extremely Premature Infants at High Risk of Rehospitalization

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Extremely low birth weight infants are at high risk of rehospitalization in infancy, often for respiratory illnesses. Few studies have evaluated which prematurely born infants will need rehospitalization or will have persistent respiratory problems after discharge. WHAT THIS STUDY ADDS:Scoring systems and classification and regression-tree analysis models were developed to identify extremely low birth weight infants at higher risk of rehospitalization and might help target interventions to infants at higher risk and assist in planning quality improvement initiatives. abstract OBJECTIVE: Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. METHODS: Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002-2005 were analyzed. The primary outcome was rehospitalization by the 18-to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. RESULTS: A total of 3787 infants were evaluated (mean Ϯ SD birth weight: 787 Ϯ 136 g; gestational age: 26 Ϯ 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%-42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of Ͼ120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of Ͼ120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. CONCLUSIONS: The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge.

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confidence: 99%

Identification of Extremely Premature Infants at High Risk of Rehospitalization

et al. 2011

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“…[6][7][8][9] During the first 3 years of life, the need for hospital care clearly decreases more in very preterm children without prematurity-related morbidities than in very preterm children with these morbidities. 10 Only a few studies have explored the costs of hospitalizations of very preterm children after the first year of life, and other health care costs have barely been evaluated. In the study by Petrou et al, 8 the hospitalization costs significantly decreased after the first year.…”

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confidence: 99%

Impact of Very Preterm Birth on Health Care Costs at Five Years of Age

et al. 2010

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“…Various studies across the world have tried to ascertain the neonatal risk factor for post NICU discharge hospital re-admission [1][2][3][8][9][10][11][12][13]. Ambalavanan, et al in their recent publication using classification and regression tree analysis concluded that neonates who spent > 120 days during their NICU admission for pulmonary reasons had a 66% re-hospitalization rate compared to 42% without such stay [3].…”

Section: Risk Factors For Hospital Re-admissionmentioning

confidence: 99%

“…Re-hospitalization after initial discharge from NICU for preterm infants has been examined in various settings across the world [1][2][3][4][5][6][7][8][9][10][11][12][13]. Reasons for re-hospitalizations in extreme preterm infants can be related either to medical (bronchiolitis, lower-respiratory tract infection, asthma, reflux disease) or to surgical (PEG related problems, V-P shunt related issues, hernia repair) causes.…”

Section: Introductionmentioning

confidence: 99%