Bonger Zelalem Tazu, Mamo Biniyam Tedla, Birra Sosna Bayu, Yalew Alemayehu Worku
Ohio State Global One Health Initiative, LLC, Addis Ababa, Ethiopia.
Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Front Pediatr. 2023 Nov 8;11:1268087. doi: 10.3389/fped.2023.1268087. eCollection 2023.
Length of hospital stay (LOS) is one of the essential indicators for evaluating the efficiency and the quality-of-care service delivered. predicting LOS is critical for resource allocation, decision-making, lowering neonatal morbidity and death, enhancing clinical outcomes and parent counseling. In addition, extended hospital stays (long LOS_NICU) place a burden on the healthcare systems decreasing bed turnover rates as well as their financial stand and the mental stress on families. In Ethiopia, there is limited evidence on the determinant factors that influence on LOS.
To determine factors affecting neonatal intensive care unit length of stay for all preterm newborns who were discharged alive.
The study used a secondary data source, was collected for the Study of Illness in Preterm (SIP) infants project. The research study was a multicenter, cross-sectional, observational clinical study that took place in five Ethiopia hospitals from July 1, 2016, to May 31, 2018. The predictors of LOS were determined using Fine-Gray's competing risk analysis.
For this study 3,511 preterm infants admitted to the NICU were analyzed. About 28.8% of the preterm infants died during their time in neonatal care while 66.6% were discharged alive. At the end of the study 4.6% babies were still in the NICU. The overall median LOS (death or discharge) was 7 days, with an interquartile range of 8 days. The cumulative incidence of discharge rose with increasing in gestational age and birth weight, on the contrary, the rate of discharge was decreased by 45.7% with the development of RDS (SDH ratio: 0.543), by 75.9% with the development of apnea (SDH ratio: 0.241), by 36.2% with sepsis, and by 43.6% with pneumonia (SDH ratio: 0.564).
Preterm newborns with a low gestational age and birth weight have a greater probability of having a prolonged LOS. Complications of the medical conditions RDS, apnea, sepsis, pneumonia, anemia, asphyxia, and NEC substantially raise LOS considerably.
住院时间（LOS）是评估医疗服务效率和质量的重要指标之一。预测住院时间对于资源分配、决策制定、降低新生儿发病率和死亡率、改善临床结局以及为家长提供咨询至关重要。此外，延长住院时间（长时间入住新生儿重症监护病房）给医疗系统带来负担，降低了病床周转率以及其财务状况，并给家庭带来精神压力。在埃塞俄比亚，关于影响住院时间的决定因素的证据有限。
确定影响所有存活出院的早产新生儿在新生儿重症监护病房住院时间的因素。
该研究使用了二次数据源，这些数据是为早产婴儿疾病研究（SIP）项目收集的。该研究是一项多中心、横断面、观察性临床研究，于2016年7月1日至2018年5月31日在埃塞俄比亚的五家医院进行。使用Fine-Gray竞争风险分析确定住院时间的预测因素。
本研究分析了3511名入住新生儿重症监护病房的早产婴儿。约28.8%的早产婴儿在新生儿护理期间死亡，66.6%存活出院。研究结束时，4.6%的婴儿仍在新生儿重症监护病房。总体中位住院时间（死亡或出院）为7天，四分位间距为8天。出院累积发生率随着胎龄和出生体重的增加而上升，相反，随着呼吸窘迫综合征（SDH比值：0.543）发展出院率下降45.7%，随着呼吸暂停发展出院率下降75.9%（SDH比值：0.241），败血症导致出院率下降36.2%，肺炎导致出院率下降43.6%（SDH比值：0.564）。
胎龄和出生体重低的早产新生儿住院时间延长的可能性更大。呼吸窘迫综合征、呼吸暂停、败血症、肺炎、贫血、窒息和坏死性小肠结肠炎等疾病并发症显著延长住院时间。
