出院标准对早产儿住院时间的影响：日本和芬兰的回顾性研究。

Impact of discharge criteria on the length of stay in preterm infants: A retrospective study in Japan and Finland.

机构信息

Department of Clinical Medicine, University of Turku, Turku, Finland; Division of Neonatology, Nagano Children's Hospital, Azumino, Japan; Life Science Research Center, Nagano Children's Hospital, Azumino, Japan.

Department of Clinical Medicine, University of Turku, Turku, Finland; Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; InFLAMES Research Flagship Center, University of Turku, Turku, Finland.

出版信息

Early Hum Dev. 2024 Jun;193:106016. doi: 10.1016/j.earlhumdev.2024.106016. Epub 2024 Apr 21.

DOI:10.1016/j.earlhumdev.2024.106016

PMID:38663141

Abstract

BACKGROUND

To shorten the hospital stay in preterm infants, it is important to understand the factors extending the length of stay.

AIMS

To understand how different discharge criteria affect the length of stay in preterm infants.

STUDY DESIGN

A retrospective comparison study.

SUBJECTS

Preterm infants born at 28 to 31 gestational weeks in 2020-2021 in a Level IV NICU in Japan (n = 22) and a Level III NICU in Finland (n = 49).

OUTCOME MEASURES

We compared the most common last discharge criteria and the postmenstrual age (PMA) between the two NICUs. The potential extending effects of each discharge criterion on the length of stay were also evaluated. The discharge criteria were classified into six categories: temperature, respiration, feeding, examination, weight limit, and family readiness.

RESULTS

The PMA at discharge was significantly higher in Japan than in Finland: median 40.7 (interquartile range 39.9-41.3) vs. 37.9 (36.9-39.0) weeks; r = 0.58; p < 0.001. The most common last discharge criterion was the family criterion in Japan (n = 19; 86 %) and the respiration criterion in Finland (n = 43; 88 %). In Japan, the length of stay was extended by 7.9 (standard deviation [SD] 7.0) days due to a lack of family readiness for discharge and 8.7 (SD 8.7) days due to not having discharged home with a feeding tube as a common practice.

CONCLUSIONS

The length of stay of preterm infants in Japan could be notably reduced by supporting the parents' earlier readiness for discharge and allowing tube feeding at home.

摘要

背景

为缩短早产儿的住院时间，了解延长住院时间的因素非常重要。

目的

了解不同的出院标准如何影响早产儿的住院时间。

研究设计

回顾性比较研究。

研究对象

2020-2021 年在日本一家四级 NICU（n=22）和芬兰一家三级 NICU（n=49）出生的 28-31 孕周的早产儿。

观察指标

我们比较了两个 NICU 之间最常见的最后出院标准和胎龄（postmenstrual age，PMA）。还评估了每个出院标准对住院时间的潜在延长影响。出院标准分为六类：体温、呼吸、喂养、检查、体重限制和家庭准备情况。

结果

日本的出院 PMA 明显高于芬兰：中位数 40.7（四分位距 39.9-41.3）比 37.9（36.9-39.0）周；r=0.58；p<0.001。日本最常见的最后出院标准是家庭标准（n=19；86%），芬兰是呼吸标准（n=43；88%）。在日本，由于家庭准备不足（n=19；86%）和未按常规出院时未带喂养管（n=19；86%），住院时间分别延长了 7.9（标准差[SD]7.0）天和 8.7（SD 8.7）天。