Division of Neonatology, The First Affiliated Hospital of Anhui Medical University, No.218, Jixi Road, Shushan District, Hefei 230022, China.
NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai 201102, China.
World J Pediatr. 2022 Feb;18(2):126-134. doi: 10.1007/s12519-021-00494-1. Epub 2022 Jan 5.
This study aimed to describe length of stay (LOS) to discharge and site variations among very preterm infants (VPIs) admitted to 57 Chinese neonatal intensive care units (NICUs) and to investigate factors associated with LOS for VPIs.
This retrospective multicenter cohort study enrolled all infants < 32 weeks' gestation and admitted to 57 NICUs which had participated in the Chinese Neonatal Network, within 7 days after birth in 2019. Exclusion criteria included major congenital anomalies, NICU deaths, discharge against medical advice, transfer to non-participating hospitals, and missing discharge date. Two multivariable linear models were used to estimate the association of infant characteristics and LOS.
A total of 6580 infants were included in our study. The overall median LOS was 46 days [interquartile range (IQR): 35-60], and the median corrected gestational age at discharge was 36 weeks (IQR: 35-38). LOS and corrected gestational age at discharge increased with decreasing gestational age. The median corrected gestational age at discharge for infants at 24 weeks, 25 weeks, 26 weeks, 27-28 weeks, and 29-31 weeks were 41 weeks, 39 weeks, 38 weeks, 37 weeks and 36 weeks, respectively. Significant site variation of LOS was identified with observed median LOS from 33 to 71 days in different hospitals.
The study provided concurrent estimates of LOS for VPIs which survived in Chinese NICUs that could be used as references for medical staff and parents. Large variation of LOS independent of infant characteristics existed, indicating variation of care practices requiring further investigation and quality improvement.
本研究旨在描述 57 家中国新生儿重症监护病房（NICU）收治的极早产儿（VPIs）的住院时间（LOS）和出院地点差异，并探讨与 VPIs LOS 相关的因素。
这是一项回顾性多中心队列研究，纳入了 2019 年在参与中国新生儿网络的 57 家 NICU 出生后 7 天内入住的所有胎龄<32 周的婴儿。排除标准包括严重先天畸形、NICU 死亡、医嘱不遵出院、转至非参与医院以及出院日期缺失。采用 2 个多变量线性模型来估计婴儿特征与 LOS 的关系。
本研究共纳入 6580 例婴儿。总体 LOS 中位数为 46 天[四分位距（IQR）：35-60]，出院时校正胎龄中位数为 36 周（IQR：35-38）。LOS 和校正胎龄随胎龄降低而增加。胎龄 24 周、25 周、26 周、27-28 周和 29-31 周的婴儿的校正胎龄出院中位数分别为 41 周、39 周、38 周、37 周和 36 周。不同医院 LOS 的观察中位数从 33 天到 71 天不等，存在显著的出院地点差异。
本研究提供了中国 NICU 中存活的 VPIs 的 LOS 同期估计值，可作为医护人员和家长的参考。LOS 存在与婴儿特征无关的巨大差异，表明护理实践存在差异，需要进一步调查和质量改进。
