苏丹东部加达里夫医院新生儿重症监护病房的住院时间及其相关因素：一项回顾性研究。
Length of stay and its associated factors in the neonatal intensive care unit of Gadarif Hospital, Eastern Sudan: a retrospective study.
作者信息
Omar Saeed M, Hassan Ahmed A, Al-Nafeesah Abdullah, AlEed Ashwaq, Alfaifi Jaber, Adam Ishag
机构信息
Faculty of Medicine, Gadarif University, Gadarif, 32211, Sudan.
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
出版信息
BMC Pediatr. 2024 Dec 19;24(1):821. doi: 10.1186/s12887-024-05318-5.
BACKGROUND
Attention is increasingly paid to length of stay (LOS) in neonatal intensive care units (NICUs) across countries. Few published data on neonatal LOS exist in Africa, where there is a high burden of neonatal morbidity and mortality. Thus, this study investigated the factors associated with neonatal LOS in the NICU of Gadarif Hospital, Eastern Sudan.
METHODS
A hospital-based retrospective study was conducted at Gadarif Hospital in Eastern Sudan from May to December 2020. Sociodemographic, maternal, and neonatal data were obtained from the hospital records. Poisson regressions were used to determine the adjusted relative risk (aRR) values and 95.0% confidence intervals (CIs).
RESULTS
This study enrolled 333 neonates admitted to the NICU and discharged alive. The median (interquartile range [IQR]) of maternal age and parity was 27.0 (23.0‒30.0) years and 3 (2‒5), respectively. Of the 333 neonates, 160 (48.0%) were males; 136 (40.8%) were delivered via cesarean section; 258 (77.5%) had low Apgar scores, and 74 (22.2%) had birth asphyxia. There were 140 (42.0%) low birth weight (LBW) neonates and 133 (39.9%) preterm neonates. The LOS range was 1-29 days (mean = 5.1 days), and its median (IQR) was 4 (2‒7) days. The multivariate Poisson analysis showed that increasing maternal age (aRR = 1.02, 95% CI = 1.01‒1.05), LBW (aRR = 1.48, 95% CI = 1.16‒1.90), preterm delivery (aRR = 1.27, 95% CI = 1.01‒1.61), a low Apgar score (aRR = 1.32, 95% CI = 1.06‒1.42), and an increasing white blood cell (WBC) count (aRR = 1.001, 95% CI = 1.001‒1.002) were associated with LOS. Parity (aRR = 0.85, 95% CI = 0.80‒0.91) was inversely associated with LOS. However, neonatal jaundice and mode of delivery were associated with LOS only in the univariate analysis.
CONCLUSION
Increasing maternal age, preterm newborn, LBW, and a low Apgar score prolonged the LOS in this region of Sudan. Healthcare providers could leverage these identified factors to predict extended neonatal LOS in Eastern Sudan, enabling proactive interventions to enhance neonatal outcomes.
背景
各国对新生儿重症监护病房（NICU）的住院时间（LOS）越来越关注。在新生儿发病率和死亡率负担较高的非洲，关于新生儿住院时间的已发表数据很少。因此，本研究调查了苏丹东部加达里夫医院新生儿重症监护病房中与新生儿住院时间相关的因素。
方法
2020年5月至12月在苏丹东部的加达里夫医院进行了一项基于医院的回顾性研究。社会人口统计学、母亲和新生儿数据从医院记录中获取。采用泊松回归确定调整后的相对风险（aRR）值和95.0%置信区间（CIs）。
结果
本研究纳入了333名入住新生儿重症监护病房且存活出院的新生儿。母亲年龄和产次的中位数（四分位间距[IQR]）分别为27.0（23.0 - 30.0）岁和3（2 - 5）。在这333名新生儿中，160名（48.0%）为男性；136名（40.8%）通过剖宫产分娩；258名（77.5%）阿氏评分低，74名（22.2%）有出生时窒息。有140名（42.0%）低出生体重（LBW）新生儿和133名（39.9%）早产儿。住院时间范围为1 - 29天（平均 = 5.1天），中位数（IQR）为4（2 - 7）天。多变量泊松分析显示，母亲年龄增加（aRR = 1.02，95% CI = 1.01 - 1.05）、低出生体重（aRR = 1.48，95% CI = 1.16 - 1.90）、早产（aRR = 1.27，95% CI = 1.01 - 1.61）、阿氏评分低（aRR = 1.32，95% CI = 1.06 - 1.42）以及白细胞（WBC）计数增加（aRR = 1.001，95% CI = 1.001 - 1.002）与住院时间相关。产次（aRR = 0.85，95% CI = 0.80 - 0.91）与住院时间呈负相关。然而，新生儿黄疸和分娩方式仅在单变量分析中与住院时间相关。
结论
母亲年龄增加、早产新生儿、低出生体重和阿氏评分低会延长苏丹该地区的住院时间。医疗保健提供者可以利用这些确定的因素来预测苏丹东部新生儿住院时间延长的情况，从而进行积极干预以改善新生儿结局。
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