Department of Health Sciences, University of Leicester, Leicester LE1 6TP, UK.
Arch Dis Child Fetal Neonatal Ed. 2010 Jul;95(4):F288-92. doi: 10.1136/adc.2009.168633. Epub 2010 Jun 7.
To describe simple estimates of likely duration of stay for very premature babies born in the UK and discharged home.
Statistical modelling of data from thirty neonatal units in a geographically defined region of the UK.
All babies born at 23 to 32 completed weeks of gestation in 2005, 2006 and 2007 who were discharged home with the expectation that they would survive.
Total duration of stay in the neonatal service.
5528 babies were initially identified. 558 (10.1%) who died or who did not follow a normal care pathway were excluded. In a further 27, data were either missing or inadequate, leaving a study population of 4702 babies. As expected, gestation and birthweight exhibited strong influence on length of stay. Of the other variables tested, initial reason for admission (need for early respiratory support) showed the most consistent association. These factors were combined to produce predictive tables. The predictive performance of the tables was found to fit the data well for various groups, with the exception of multiple births who tended to have longer stays. However, when tested against individual units, much greater variation was seen independent of unit size and case mix.
The prediction tables should permit parents to make sensible estimates about the duration of their baby's stay in the neonatal service; however, there appear to be important differences between units. The variation noted in length of stay between otherwise similar units merits further investigation.
描述英国出生的极早产儿出院回家后预计住院时间的简单估计方法。
对英国一个地理位置明确的地区 30 个新生儿病房的数据进行统计建模。
2005 年、2006 年和 2007 年在 23 至 32 周胎龄出生且预计存活并出院回家的所有婴儿。
新生儿服务的总住院时间。
最初确定了 5528 名婴儿。558 名(10.1%)死亡或未遵循常规护理路径的婴儿被排除在外。另外还有 27 名婴儿的数据缺失或不完整,最终研究人群为 4702 名婴儿。与预期的一样,胎龄和出生体重对住院时间有很大影响。在测试的其他变量中,入院的初始原因(需要早期呼吸支持)显示出最一致的关联。将这些因素结合起来制成预测表。发现这些表格在各种组别中的预测性能与数据拟合良好,除了多胞胎的住院时间往往更长之外。然而,当将其与个别病房进行比较时,发现即使在病房规模和病例组合相似的情况下,也存在很大的差异。
预测表可以让父母对婴儿在新生儿病房的住院时间做出合理的估计;然而,不同病房之间似乎存在重要差异。在其他方面相似的病房之间,住院时间的差异值得进一步调查。