University of Leicester
Browse

Duration and Time Trends in Hospital Stay for Very Preterm Infants Differ Across European Regions

Download (4.53 MB)
journal contribution
posted on 2019-02-22, 12:36 authored by RF Maier, B Blondel, A Piedvache, B Misselwitz, S Petrou, P Van Reempts, F Franco, H Barros, J Gadzinowski, K Boerch, A van Heijst, ES Draper, J Zeitlin, MOSAIC and EPICE Research Groups
OBJECTIVES: To compare duration and changes over time in length of hospital stay for very preterm and extremely preterm infants in 10 European regions. DESIGN: Two area-based cohort studies from the same regions in 2003 and 2011/2012. SETTING: Ten regions from nine European countries. PATIENTS: Infants born between 22 + 0 and 31 + 6 weeks of gestational age and surviving to discharge (Models of Organising Access to Intensive Care for Very Preterm Births cohort in 2003, n = 4,011 and Effective Perinatal Intensive Care in Europe cohort in 2011/2012, n = 4,336). INTERVENTIONS: Observational study, no intervention. MEASUREMENTS AND MAIN RESULTS: Maternal and infant characteristics were abstracted from medical records using a common protocol and length of stay until discharge was adjusted for case-mix using negative binomial regression. Mean length of stay was 63.6 days in 2003 and varied from 52.4 to 76.5 days across regions. In 2011/2012, mean length of stay was 63.1 days, with a narrower regional range (54.0-70.1). Low gestational age, small for gestational age, low 5-minute Apgar score, surfactant administration, any surgery, and severe neonatal morbidities increased length of stay. Infant characteristics explained some of the differences between regions and over time, but large variations remained after adjustment. In 2011/2012, mean adjusted length of stay ranged from less than 54 days in the Northern region of the United Kingdom and Wielkopolska, Poland to over 67 days in the Ile-de-France region of France and the Eastern region of the Netherlands. No systematic decrease in very preterm length of stay was observed over time after adjustment for patient case-mix. CONCLUSIONS: A better understanding of the discharge criteria and care practices that contribute to the wide differences in very preterm length of stay across European regions could inform policies to optimize discharge decisions in terms of infant outcomes and health system costs.

History

Citation

Pediatr Crit Care Med, 2018, 19 (12), pp. 1153-1161

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences

Version

  • AM (Accepted Manuscript)

Published in

Pediatr Crit Care Med

Publisher

Lippincott, Williams & Wilkins for: 1. Japanese Society of Pediatric Intensive and Critical Care 2. Latin American Society of Pediatric Intensive Care 3. Pediatric Intensive Care Society UK 4. Society of Critical Care Medicine 5. World Federation of

issn

1529-7535

eissn

1947-3893

Copyright date

2018

Available date

2019-02-22

Publisher version

https://journals.lww.com/pccmjournal/fulltext/2018/12000/Duration_and_Time_Trends_in_Hospital_Stay_for_Very.8.aspx

Language

en

Usage metrics

    University of Leicester Publications

    Categories

    No categories selected

    Keywords

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC