Re-hospitalization in infants younger than 29 weeks' gestation in the EPIPAGE cohort

Lamarche-Vadel, Agathe; Blondel, Béatrice; Truffert, Patrick; Burguet, A.; Cambonie, Gilles; Selton, D.; Arnaud, Catherine; Lardennois, Caroline; Mazaubrun, Christiane Du; Nguyen, Sylvie; Mathis, J; Breart, Gérard; Kaminski, Monique

doi:10.1080/08035250410032926

Cited by 36 publications

(20 citation statements)

References 26 publications

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“…The rehospitalization rate for patients enrolled in this trial was 43.4% in the first year of life and 57.8% during the 4.5 year follow-up, which is consistent with other studies with similar enrollment criteria [17, 19, 20, 22, 23]. The finding that almost 30% of subjects required multiple hospital readmissions, averaging 3.9 admissions over the study period, is remarkable and demonstrates a high degree of morbidity in these infants.…”

Section: Discussionsupporting

confidence: 90%

“…The finding that almost 30% of subjects required multiple hospital readmissions, averaging 3.9 admissions over the study period, is remarkable and demonstrates a high degree of morbidity in these infants. The risk factors for hospital readmission that have been previously identified [8, 17, 19, 20] are similar to those we identified for readmission to the ICU. One notable difference is the lack of CLD as a risk factor for either hospital or ICU readmission in our study.…”

Section: Discussionsupporting

confidence: 81%

“…Although it has been well-reported that preterm infants are at high risk for rehospitalization [6, 8, 17–20], few studies have examined the incidence of readmission to an ICU in this population. A single center study following 217 infants born at 24 to 28 weeks’ gestation from 1987 to 1992 found a rehospitalization rate of 48% and ICU readmission rate of 6% during the 18 month follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies found hospital readmission rates in preterm infants ranging from 15–50%, depending on the inclusion criteria for degree of prematurity or birth weight [5, 8, 17, 19–21]. The rehospitalization rate for patients enrolled in this trial was 43.4% in the first year of life and 57.8% during the 4.5 year follow-up, which is consistent with other studies with similar enrollment criteria [17, 19, 20, 22, 23].…”

Section: Discussionmentioning

confidence: 99%

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Intensive Care Unit Readmission during Childhood after Preterm Birth with Respiratory Failure

Mourani

Kinsella

Clermont

et al. 2014

The Journal of Pediatrics

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Objective To determine the incidence and risk factors for intensive care unit (ICU) readmission among preterm infants who required mechanical ventilation at birth. Study design We studied preterm newborns (birth weight 500–1250 grams) who required mechanical ventilation at birth and were enrolled in a multicenter trial of inhaled nitric oxide therapy. Patients were assessed up to 4.5 years of age via annual in-person evaluations and structured telephone interviews. Univariate and multivariable analyses of baseline and birth hospitalization predictors of ICU readmission were performed. Results Of 512 subjects providing follow-up data, 58% were readmitted to the hospital (51% of these had multiple readmissions, averaging 3.9 readmissions per subject), 19% were readmitted to an ICU, and 12% required additional mechanical ventilation support. In univariate analyses, ICU readmission was more common among males (OR 2.01; 95% CI, 1.27–3.18), infants with grade 3–4 intracranial hemorrhage (OR 2.13; 95% CI, 1.23–3.69), increasing duration of birth hospitalization (OR 1.01 per day; 95% CI: 1.00–1.02), and prolonged oxygen therapy (OR 1.01 per day; 95% CI 1.00–1.01). In the first year after birth hospitalization, children readmitted to an ICU incurred higher health care costs (median $69,700 vs. $30,200 for subjects admitted to the ward and $9600 for subjects never admitted). Conclusions Small preterm infants who were mechanically ventilated at birth have substantial risk for readmission to an ICU and late mechanical ventilation, using extensive health care resources and incurring high costs.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intensive Care Unit Readmission during Childhood after Preterm Birth with Respiratory Failure

Mourani

Kinsella

Clermont

et al. 2014

The Journal of Pediatrics

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“…The EPIPAGE study demonstrated that preterm infants discharged with lower weight and postmenstrual age did not have higher rates of re-hospitalization, and that the number of re-admissions was not correlated with the initial LOS [11]. It seems conceivable that LOS can be influenced by the age in which the newborn leaves the incubator.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of transferring intensive cared preterm infants from incubator to open crib at 1600 grams

et al. 2014

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BackgroundAbility to maintain a normal body temperature in an open crib is an important physiologic competency generally requested to discharge preterm infants from the hospital. The aim of this study is to assess the feasibility of an early weaning protocol from incubator in preterm newborns in a Neonatal Intensive Care Unit.Methods101 infants with birth weight < 1600 g were included in this feasibility study. We compared 80 newborns successfully transferred from an incubator to open crib at 1600 g with 21 infants transferred at weight ≥ 1700 g. The primary outcome was to evaluate feasibility of the protocol and the reasons for the eventual delay. Secondary outcomes were the identification of factors that would increase the likelihood of early weaning, the impact of an earlier weaning on discharge timing, and the incidence of adverse outcomes. Newborns in the study period were then compared with an historical control group with similar characteristics.ResultsEarly weaning was achieved in 79.2% of infants without significant adverse effects on temperature stability or weight gain. Delayed weaning was mainly due to the need of respiratory support. Gestational age affected the likelihood of early weaning (OR 1.7282 95% CI: 1.3071 - 2.2850). In the multivariate linear regression, early weaning reduced length of stay (LOS) by 25.8 days (p < 0.0001).ConclusionsPreterm infants can be weaned successfully from an incubator to an open crib at weight as low as 1600 grams without significant adverse effect. Early weaning significantly reduces LOS in preterm newborns.

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Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the US, 2013-2018

Bell

Hintz

Hansen

et al. 2022

JAMA

367

105

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Key PointsQuestionAmong extremely preterm infants born at US academic medical centers between 2013 and 2018, what were mortality, in-hospital morbidity, and 2-year neurodevelopmental outcomes?FindingsIn this observational study based on a prospective registry of 10 877 infants born at 22-28 weeks’ gestational age in 2013-2018 in 19 US academic medical centers, survival to discharge occurred in 78.3% and was significantly improved compared with a historical rate of 76.0% among infants born in 2008-2012. Among infants born at less than 27 weeks’ gestational age who survived to follow-up assessment at 2 years, 49.9% had been rehospitalized and severe neurodevelopmental impairment occurred in 21.2%.MeaningAmong extremely preterm infants born at US academic medical centers from 2013 to 2018, survival to discharge significantly improved compared with infants born in 2008-2012, but among those born at less than 27 weeks’ gestational age, rehospitalization and neurodevelopmental impairment at 2 years were common.

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Re-hospitalization in infants younger than 29 weeks' gestation in the EPIPAGE cohort

Abstract: Infants born before 29 wk have a very high risk of re-hospitalization. The associated factors can help define high-risk groups at discharge from the neonatal unit who need special surveillance.

Cited by 36 publications

References 26 publications

Intensive Care Unit Readmission during Childhood after Preterm Birth with Respiratory Failure

Intensive Care Unit Readmission during Childhood after Preterm Birth with Respiratory Failure

Feasibility of transferring intensive cared preterm infants from incubator to open crib at 1600 grams

Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the US, 2013-2018

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