A study on the length of stay of neonates in neonatal intensive care unit in a referral hospital in India

Kanimozhi, P.; Kumaravel, K S; Velmurugan, K

doi:10.18203/2349-3291.ijcp20190723

Cited by 3 publications

References 11 publications

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Potential health and cost impacts of a point-of-care test for neonatal sepsis and possible serious bacterial infections in infants: a modeling analysis in two settings

Chevalier,

Hansen,

Grantz

et al. 2024

Preprint

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Introduction Sepsis accounts for up to 50% of neonatal deaths in resource-limited countries. Accurate and timely diagnosis could improve clinical outcomes, reduce inappropriate antibiotic use, and provide healthcare cost savings. We aimed to identify the minimum technical specifications and cost required of a point-of-care test (POCT) for neonatal sepsis to be clinically useful in hospital and community levels in low-resource settings. Methods We modeled the diagnosis and treatment of two cohorts: hospitalized neonates and infants presenting to primary health care facilities with suspected sepsis. We compared health outcomes, including mortality, length of hospital stays, and acquisition of healthcare-associated infections (HAIs), under a POCT compared to empiric treatment and blood culture across varying test performance, prevalence of bacterial infection and discharge eligibility. A threshold health economic analysis was performed to determine the allowable POCT price to remain cost neutral to the healthcare system. Results A POCT could lead to a net reduction in neonatal deaths at both the hospital level (up to 19% of deaths averted compared to baseline) and community level (up to 76% deaths averted) through faster initiation of appropriate therapy and reducing unnecessary hospitalizations and HAIs. Healthcare costs could be reduced substantially with implementation of a POCT (17%-43% of baseline costs saved in hospital and 48%-81% saved in primary healthcare settings across the range of analyzed scenarios), suggesting a POCT costing up to $21 in hospitals and $3 in community settings could be cost neutral. Conclusions A POCT for neonatal sepsis, even with imperfect accuracy, could substantially improve clinical outcomes by improving time to diagnosis, while also supporting antibiotic de-escalation and stewardship and lowering healthcare costs. However, high clinical sensitivity is required to avoid causing deaths through missed diagnoses due to false negative results and delayed antibiotic initiation.

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Potential health and cost impacts of a point-of-care test for neonatal sepsis and possible serious bacterial infections in infants: a modeling analysis in two settings

Chevalier,

Hansen,

Grantz

et al. 2024

Preprint

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Quantitative and qualitative analysis of antibiotic use among neonatal patients in teaching hospitals in Indonesia

Yulistiani,

Lestari,

Utomo

et al. 2024

PHAR

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Patients in the neonatal intensive care unit (NICU) are at a heightened risk of bacterial infection. The administration of antibiotics in the NICU varies widely, and inappropriate use can cause resistance, underscoring the need to monitor rationale use through an antimicrobial stewardship program. Therefore, this study aimed to evaluate the quantity and quality of antibiotic prescriptions for neonates in the NICU at Airlangga University Hospital. A retrospective observational study was conducted on patients admitted to the NICU from January 1, 2021, to December 31, 2022. The quantity of antibiotics was determined using the defined daily dose (DDD) method, and the quality of prescriptions was evaluated using the Gyssens algorithm. The results showed that based on the quantitative analysis using the DDD 100 patient-days method, the most common antibiotic used was ampicillin-sulbactam. Meanwhile, the qualitative study using the Gyssens method showed that 91% of antibiotic use was in category 0 (rational).

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The Impact of Maternal Risk Factors on Neonatal Morbidity and Mortality in a Tertiary Care Neonatal Intensive Care Unit (NICU): An Observational Study

Wandile,

Waghmode,

Uke

et al. 2024

Cureus

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Background: Neonatal morbidity and mortality continue to be major public health issues globally, especially for infants admitted to neonatal intensive care units (NICUs). This study aims to investigate the incidence of morbidities among neonates born to high-risk mothers and to evaluate the impact of various maternal risk factors on neonatal morbidity and mortality in the NICU setting. Methods: This prospective observational study was conducted on 1,000 newborns up to 28 days of life, all with maternal risk factors, born in our tertiary care center, and admitted to the NICU. Results: Most NICU admissions occurred during the 34-36 weeks of gestation, comprising 412 (41.20%) of the total admissions. Additionally, there was a female predominance, with 552 cases, representing 55.20% of the admissions. Most of the NICU patients came from rural background 594 (59.40%) and belonged to socioeconomic status (SES) IV 764 (76.40%). Higher percentages of neonatal morbidities were observed among children of illiterate and primarily educated mothers, amounting to 913 cases (91.30%). After evaluating patients in the NICU, we found that mortality was 172 (17.20%). Mothers with previous bad obstetric histories were at greater risk of poor neonatal outcomes. Cesarean sections were more commonly associated with NICU admissions, accounting for 555 cases (55.50%). The primary risk factors included pregnancy-induced hypertension, previous lower segment cesarean section, fetal distress, and premature rupture of membranes. Significant neonatal morbidities included respiratory distress syndrome (RDS) due to prematurity 79 (45.9%), intrauterine growth retardation 19 (11.0%), meconium aspiration syndrome 16 (9.3%), birth asphyxia, sepsis 29 (16.8%), and congenital anomalies 12 (6.9%). RDS was identified as the leading cause of morbidity. Conclusion: The present study highlights several critical factors associated with NICU admissions and neonatal morbidities, underscoring the need for targeted interventions to improve neonatal health outcomes.

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A study on the length of stay of neonates in neonatal intensive care unit in a referral hospital in India

Cited by 3 publications

References 11 publications

Potential health and cost impacts of a point-of-care test for neonatal sepsis and possible serious bacterial infections in infants: a modeling analysis in two settings

Potential health and cost impacts of a point-of-care test for neonatal sepsis and possible serious bacterial infections in infants: a modeling analysis in two settings

Quantitative and qualitative analysis of antibiotic use among neonatal patients in teaching hospitals in Indonesia

The Impact of Maternal Risk Factors on Neonatal Morbidity and Mortality in a Tertiary Care Neonatal Intensive Care Unit (NICU): An Observational Study

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