Alhamawi Noha J, Alharbi Hadeel A, Alqahtani Mohammed H
Pediatrics, King Fahad Medical City, Riyadh, SAU.
Neonatology, Al Yamamah Hospital, Riyadh, SAU.
Cureus. 2024 Nov 18;16(11):e73892. doi: 10.7759/cureus.73892. eCollection 2024 Nov.
There is a significant challenge in predicting the duration of the neonatal hospital length of stay (LOS) due to the complicated factors that affect newborns. Most studies are conducted among pre-term neonates, in which the gestational age is lower than 37 weeks and the birth weight of patients is considered a major risk factor for a prolonged LOS. No previous systematic review of the literature was conducted among the full-term population. This review aims to determine the risk factors for neonatal intensive care unit (NICU) LOS from multiple studies affecting full-term patients. The included studies focused on assessing reasons and factors affecting the NICU LOS of newborns, including "full-term newborns." We included studies that considered the NICU LOS as the primary outcome. Both retrospective and prospective studies were eligible for inclusion. The risk of bias for the included studies was evaluated using the Quality in Prognosis Studies (QUIPS) tool suggested by the Cochrane Prognosis Methods Group. The literature search of the databases identified 637 potentially relevant articles, among which 10 met the inclusion criteria and were selected for this review. Among the 10 studies, three risk factors were identified: disease-related, parent-related, and inherent factors. These factors constitute a critical risk factor most widely studied and consistently associated with LOS for the full-term population. Our findings offer an updated extensive summary of this aspect that has not been considered in detail in the literature. In conclusion, several critical risk factors affecting neonatal LOS were discovered in the published studies in this systematic review. However, there is a need for more prospective studies with standardized approaches that are crucial to confirm these findings and help develop effective interventions.
由于影响新生儿的因素复杂，预测新生儿住院时长（LOS）具有重大挑战。大多数研究是在孕周低于37周的早产儿中进行的，其中患者的出生体重被认为是住院时长延长的主要风险因素。此前尚未对足月儿群体进行过系统的文献综述。本综述旨在通过多项研究确定影响足月儿患者新生儿重症监护病房（NICU）住院时长的风险因素。纳入的研究重点评估影响新生儿NICU住院时长的原因和因素，包括“足月儿”。我们纳入了将NICU住院时长作为主要结局的研究。回顾性研究和前瞻性研究均符合纳入标准。使用Cochrane预后方法组建议的预后研究质量（QUIPS）工具评估纳入研究的偏倚风险。对数据库的文献检索共识别出637篇潜在相关文章，其中10篇符合纳入标准并被选入本综述。在这10项研究中，确定了三个风险因素：疾病相关因素、家长相关因素和固有因素。这些因素构成了针对足月儿群体研究最广泛且与住院时长始终相关的关键风险因素。我们的研究结果提供了这方面的最新广泛总结，而这在文献中尚未得到详细考虑。总之，在本系统综述的已发表研究中发现了几个影响新生儿住院时长的关键风险因素。然而，需要更多采用标准化方法的前瞻性研究，这对于证实这些发现并帮助制定有效的干预措施至关重要。
