Identification of extremely premature infants at high risk of rehospitalization.

Szczegóły
Abstrakt

Tytuł:: Identification of extremely premature infants at high risk of rehospitalization.
Autorzy:: Ambalavanan N; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35249-7335, USA. />Carlo WA
McDonald SA
Yao Q
Das A
Higgins RD
Corporate Authors:: Generic Database and Follow-up Subcommittees of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Źródło:: Pediatrics [Pediatrics] 2011 Nov; Vol. 128 (5), pp. e1216-25. Date of Electronic Publication: 2011 Oct 17.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: Elk Grove Village Il : American Academy of Pediatrics
Original Publication: Springfield, Ill., Thomas.
MeSH Terms:: Infant, Extremely Low Birth Weight*
Infant, Newborn, Diseases/*epidemiology
Infant, Newborn, Diseases/*therapy
Patient Readmission/*statistics & numerical data
Respiratory Tract Diseases/*therapy
Databases, Factual ; Female ; Follow-Up Studies ; Gestational Age ; Hospitalization/statistics & numerical data ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases/diagnosis ; Logistic Models ; Male ; Odds Ratio ; Predictive Value of Tests ; Pregnancy ; Regression Analysis ; Respiratory Tract Diseases/diagnosis ; Respiratory Tract Diseases/epidemiology ; Retrospective Studies ; Risk Assessment ; Survival Analysis ; Time Factors ; United States
References:: J Pediatr. 2009 Aug;155(2):217-21.e1. (PMID: 19447409)
Pediatrics. 2003 Dec;112(6 Pt 1):1442-6. (PMID: 14654627)
J Pediatr. 1996 Apr;128(4):447-52. (PMID: 8618176)
Pediatrics. 2005 Mar;115(3):696-703. (PMID: 15741374)
Pediatrics. 2009 Jul;124(1):128-34. (PMID: 19564292)
Pediatrics. 2007 Jul;120(1):e1-9. (PMID: 17606536)
Acta Paediatr. 2004 Oct;93(10):1340-5. (PMID: 15499955)
Pediatr Neurosurg. 2010;46(3):221-6. (PMID: 21051921)
Pediatrics. 2010 Sep;126(3):443-56. (PMID: 20732945)
J Pediatr. 2006 Apr;148(4):438-444. (PMID: 16647401)
J Pediatr. 2005 Jun;146(6):798-804. (PMID: 15973322)
J Clin Epidemiol. 1998 Mar;51(3):199-209. (PMID: 9495685)
J Neurosurg Pediatr. 2009 Feb;3(2):94-100. (PMID: 19278306)
J Perinatol. 2007 Oct;27(10):614-9. (PMID: 17717521)
Pediatrics. 2006 Nov;118(5):2084-93. (PMID: 17079582)
J Perinatol. 1997 Sep-Oct;17(5):375-82. (PMID: 9373843)
JAMA. 2003 Mar 5;289(9):1124-9. (PMID: 12622582)
J Perinatol. 2005 Oct;25(10):656-63. (PMID: 16107873)
Pediatrics. 2009 Apr;123(4):1132-41. (PMID: 19336372)
J Infect. 2005 Jun;50(5):397-403. (PMID: 15907547)
JAMA. 2000 Oct 25;284(16):2070-6. (PMID: 11042755)
Pediatrics. 2000 Jun;105(6):1216-26. (PMID: 10835060)
N Engl J Med. 2008 Apr 17;358(16):1672-81. (PMID: 18420500)
Grant Information:: U10 HD27851 United States HD NICHD NIH HHS; R03 HD054420 United States HD NICHD NIH HHS; U10 HD40492 United States HD NICHD NIH HHS; U10 HD021364 United States HD NICHD NIH HHS; U10 HD40521 United States HD NICHD NIH HHS; M01 RR633 United States RR NCRR NIH HHS; KL2 RR24149 United States RR NCRR NIH HHS; KL2 RR024149 United States RR NCRR NIH HHS; UL1 RR024160 United States RR NCRR NIH HHS; U10 HD21397 United States HD NICHD NIH HHS; UL1 RR24160 United States RR NCRR NIH HHS; U10 HD21385 United States HD NICHD NIH HHS; M01 RR006022 United States RR NCRR NIH HHS; U10 HD027856 United States HD NICHD NIH HHS; U10 HD40689 United States HD NICHD NIH HHS; U10 HD021373 United States HD NICHD NIH HHS; UL1 RR024139 United States RR NCRR NIH HHS; U10 HD021385 United States HD NICHD NIH HHS; M01 RR44 United States RR NCRR NIH HHS; M01 RR6022 United States RR NCRR NIH HHS; U10 HD21364 United States HD NICHD NIH HHS; U10 HD34216 United States HD NICHD NIH HHS; U10 HD027880 United States HD NICHD NIH HHS; M01 RR70 United States RR NCRR NIH HHS; U10 HD36790 United States HD NICHD NIH HHS; U10 HD040521 United States HD NICHD NIH HHS; U10 HD27880 United States HD NICHD NIH HHS; M01 RR008084 United States RR NCRR NIH HHS; M01 RR125 United States RR NCRR NIH HHS; U10 HD27904 United States HD NICHD NIH HHS; U10 HD040461 United States HD NICHD NIH HHS; U10 HD40498 United States HD NICHD NIH HHS; U10 HD27871 United States HD NICHD NIH HHS; M01 RR016587 United States RR NCRR NIH HHS; M01 RR7122 United States RR NCRR NIH HHS; U10 HD040689 United States HD NICHD NIH HHS; U10 HD040492 United States HD NICHD NIH HHS; U10 HD027853 United States HD NICHD NIH HHS; U10 HD027904 United States HD NICHD NIH HHS; UL1 RR24148 United States RR NCRR NIH HHS; U10 HD021397 United States HD NICHD NIH HHS; U10 HD27856 United States HD NICHD NIH HHS; U10 HD40461 United States HD NICHD NIH HHS; U10 HD27853 United States HD NICHD NIH HHS; M01 RR39 United States RR NCRR NIH HHS; M01 RR30 United States RR NCRR NIH HHS; UL1 TR000454 United States TR NCATS NIH HHS; U10 HD027871 United States HD NICHD NIH HHS; UL1 RR024148 United States RR NCRR NIH HHS; M01 RR007122 United States RR NCRR NIH HHS; U10 HD027851 United States HD NICHD NIH HHS; M01 RR80 United States RR NCRR NIH HHS; M01 RR16587 United States RR NCRR NIH HHS; M01 RR750 United States RR NCRR NIH HHS; M01 RR8084 United States RR NCRR NIH HHS; U10 HD21373 United States HD NICHD NIH HHS; M01 RR32 United States RR NCRR NIH HHS; U10 HD034216 United States HD NICHD NIH HHS; U10 HD036790 United States HD NICHD NIH HHS; UL1 RR24139 United States RR NCRR NIH HHS; U10 HD040498 United States HD NICHD NIH HHS
Contributed Indexing:: Investigator: BJ Stoll; EF Bell; MC Walsh; S Shankaran; AR Laptook; RD Higgins; A Das; NS Newman; EC Hale; BR Vohr; AM Dusick; PW Evans; M Peralta-Carcelen; MJ Acarregui; RJ Heyne; K Yolton; A Das; RD Higgins; AH Jobe; MS Caplan; AR Laptook; W Oh; BR Vohr; A Hensman; TM Leach; MR Leonard; JR Moore; L Noel; BE Stephens; R Burke; Y Yatchmink; RV Walden; VE Watson; MC Walsh; AA Fanaroff; D Wilson-Costello; NS Newman; BS Siner; K Schibler; EF Donovan; JJ Steichen; K Bridges; B Alexander; C Grisby; MW Mersmann; HL Mincey; J Hessling; TL Gratton; RN Goldberg; CM Cotten; RF Goldstein; KJ Auten; KA Fisher; MB Lohmeyer; BJ Stoll; DP Carlton; I Adams-Chapman; EC Hale; LL Wright; EM McClure; BB Poindexter; JA Lemons; AM Dusick; DD Appel; DE Herron; LC Miller; LD Wilson; WK Poole; B Hastings; EN McClure; JE Newman; JO Auman; CM Huitema; KM Zaterka-Baxter; KP Van Meurs; SR Hintz; DK Stevenson; MB Ball; JM Baran; LE Bond; GK Brudos; S Davis; AM DeBattista; BE Fleisher; JG Kohn; JC Lee-Ancajas; RP Pyle; D Sivakumar; NH St John; M Peralta-Carcelen; MV Collins; SS Cosby; VA Phillips; NN Finer; YE Vaucher; MR Rasmussen; D Kaegi; K Arnell; C Demetrio; MG Fuller; C Henderson; W Rich; CR Bauer; S Duara; S Hiriart-Fajardo; R Everett-Thomas; M Allison; AN Diaz; SF Eguaras; YC Gideon; A Riguard; A Stoerger; A Garcia; H Pierre; K Hamlin-Smith; DL Phelps; GJ Myers; LJ Reubens; M Rowan; E Burnell; D Hust; RL Jensen; L Zwetsch; JB Johnson; E Kushner; J Merzbach; K Yost; WA Salhab; PJ Sánchez; CR Rosenfeld; AR Laptook; RJ Heyne; SS Adams; C Dooley; A Guzman; G Hensley; JF Hickman; LA Madden; S Madison; NA Miller; JS Morgan; CT Boatman; E Heyne; KA Kennedy; JE Tyson; BH Morris; PJ Bradt; PW Evans; EG Akpa; NI Alaniz; PA Cluff; M Currence; CI Franco; AE Lis; GE McDavid; PL Tate; LL Whiteley; SL Wright; TM O'Shea; LK Washburn; RG Dillard; NJ Peters; BG Jackson; K Chiu; DE Allred; DJ Goldstein; R Halfond; C Peterson; EL Waldrep; MW Morris; GW Hounshell; S Shankaran; YR Johnson; A Pappas; R Bara; G Muran; D Kennedy; LA Goldston; RA Ehrenkranz; P Gettner; HC Jacobs; C Butler; P Cervone; M Konstantino; E Romano; J Poulsen; J Taft; J Williams; S Greisman
Entry Date(s):: Date Created: 20111019 Date Completed: 20120124 Latest Revision: 20221014
Update Code:: 20240104
PubMed Central ID:: PMC3208965
DOI:: 10.1542/peds.2011-1142
PMID:: 22007016
: Czasopismo naukowe

Objective: Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization.
Methods: Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002-2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables.
Results: A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%-42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay.
Conclusions: The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge.

Informacja