Department of Pediatrics, Zuckerberg San Francisco General Hospital at the University of California San Francisco, San Francisco, CA, USA.
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
J Perinatol. 2022 May;42(5):624-630. doi: 10.1038/s41372-021-01276-3. Epub 2021 Nov 23.
To assess risk factors associated with 30-day hospital readmission after a prolonged neonatal intensive care stay.
Retrospective analysis of 57,035 infants discharged >14 days from the NICU between 2013 and 2016. Primary outcome was 30-day, all-cause hospital readmission. Adjusted likelihood of readmission accounting for demographic and clinical characteristics, including chronic conditions was also estimated.
The 30-day readmission rate was 10.7%. Respiratory problems accounted for most (31.0%) readmissions. In multivariable analysis, shunted hydrocephalus [OR 2.2 (95%CI 1.8-2.7)], gastrostomy tube [OR 2.0 (95%CI 1.8-2.3)], tracheostomy [OR 1.5 (95%CI 1.2-1.8)], and use of public insurance [OR 1.3 (95%CI 1.2-1.4)] had the highest likelihood of readmission. Adjusted hospital readmission rates varied significantly (p < 0.001) across hospitals.
The likelihood of hospital readmission was highest for infants with indwelling medical devices and public insurance. These findings will inform future initiatives to reduce readmission for high risk infants with medical and social complexity.
评估新生儿重症监护病房（NICU）延长住院时间后 30 天内再次住院的相关风险因素。
回顾性分析了 2013 年至 2016 年间出院时间超过 14 天的 57035 名婴儿。主要结局为 30 天内全因再次住院。还估计了考虑人口统计学和临床特征（包括慢性疾病）后再次入院的调整可能性。
30 天的再入院率为 10.7%。呼吸系统问题导致了大多数（31.0%）再入院。多变量分析显示，分流性脑积水[比值比（OR）2.2（95%置信区间[CI]1.8-2.7）]、胃造口管[OR 2.0（95%CI 1.8-2.3）]、气管造口术[OR 1.5（95%CI 1.2-1.8）]和使用公共保险[OR 1.3（95%CI 1.2-1.4）]的再入院可能性最高。调整后的住院再入院率在各医院之间差异显著（p<0.001）。
留置医疗设备和公共保险的婴儿再次住院的可能性最高。这些发现将为未来减少具有医疗和社会复杂性的高危婴儿再入院的举措提供信息。
