Attar Mohammad A, Lang Sylvia W, Gates Molly R, Iatrow Ann M, Bratton Susan L
Department of Pediatrics and Communicable Diseases, University of Michigan, MI 48109-0254, USA.
J Perinatol. 2005 Nov;25(11):731-6. doi: 10.1038/sj.jp.7211391.
In a regionalized perinatal system, recovering neonates may be back transported from a regional Neonatal Intensive Care Unit (NICU) to community hospitals closer to their residence to convalesce prior to hospital discharge.
This study evaluates the practice of neonatal back transport for growth and the duration of total hospitalization.
We conducted a retrospective study comparing length of stay (LOS) for infants back transported from a regional NICU to a level II nursery for convalescent care (BT), with LOS for infants eligible for back transport discharged home from the Regional Center (RC).
A total of 221 infants were studied. BT infants (n=104) had lower birth weights (median; 1955 vs 2700 g, p=0.001), more frequently needed mechanical ventilation (84 vs 65%, p=0.002) and parenteral nutrition (71 vs 55%, p=0.013), less frequently were evaluated by subspecialists (20 vs 59% p=0.0001), and had longer total LOS (median; 20 vs 11 days, p<0.0001) compared to infants discharged home from the RC (n=117). However, in the subgroup with birth weights <or=1500 g (very low birth weight (VLBW)), BT (n=25) infants had similar birth weight (median; 1160 vs 1215 g, p=0.9) compared to those discharged home from the RC (n=24) and did not have a statistically different total LOS (median; 50 vs 56 days, p=0.1). Almost all infants who had major surgeries, treatment for retinopathy of prematurity, seizures, or had severe intra-ventricular hemorrhages were discharged home from the RC. The rates of hospital readmissions or emergency room visits acutely after their discharge to home from the RC or the community hospital were similar.
BT Infants differed based on clinical features compared to premature infants discharged from the RC. VLBW infants, back transported for growth, had similar total LOS compared to similar weight infants discharged home from the RC.
在区域化围产期系统中，康复中的新生儿可能会从区域新生儿重症监护病房（NICU）被转回离其住所更近的社区医院，以便在出院前进行康复治疗。
本研究评估新生儿转回康复治疗对其生长发育及总住院时长的影响。
我们开展了一项回顾性研究，比较从区域NICU转回二级保育室进行康复护理的婴儿（转回组）的住院时长（LOS），与符合转回条件、从区域中心（RC）直接出院回家的婴儿的住院时长。
共研究了221名婴儿。与从RC出院回家的婴儿（n = 117）相比，转回组婴儿（n = 104）出生体重更低（中位数：1955 vs 2700 g，p = 0.001），更频繁需要机械通气（84% vs 65%，p = 0.002）和肠外营养（71% vs 55%，p = 0.013），接受亚专科医生评估的频率更低（20% vs 59%，p = 0.0001），总住院时长更长（中位数：20 vs 11天，p < 0.0001）。然而，在出生体重≤1500 g（极低出生体重（VLBW））的亚组中，转回组（n = 25）婴儿与从RC出院回家的婴儿（n = 24）出生体重相似（中位数：1160 vs 1215 g，p = 0.9），总住院时长无统计学差异（中位数：50 vs 56天，p = 0.1）。几乎所有接受过大手术、患有早产儿视网膜病变、癫痫或严重脑室内出血并接受治疗的婴儿都从RC直接出院回家。从RC或社区医院出院回家后急性再入院或急诊就诊的发生率相似。
与从RC出院的早产儿相比，转回组婴儿的临床特征有所不同。因生长发育需要转回康复治疗的VLBW婴儿与从RC出院回家的同体重婴儿总住院时长相似。
