The Effect of Early Discharge and Other Factors on Readmission Rates of Newborns

Soskolne, Errol I.; Schumacher, Robert E.; Fyock, Carole; Young, Mary Lynn; Schork, Anthony

doi:10.1001/archpedi.1996.02170290039006

Cited by 93 publications

(49 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21 Late-preterm infants also have immature gastrointestinal function 57,58 and feeding difficulties that predispose them to an increase in enterohepatic circulation, decreased stool frequency, dehydration, and hyperbilirubinemia. [59][60][61][62][63][64][65][66][67][68] Feeding during the birth hospitalization may be transiently successful but not sustained after discharge. Feeding difficulties in late-preterm infants that are associated with relatively low oromotor tone, function, and neural maturation also predispose these infants to dehydration and hyperbilirubinemia.…”

Section: Developmental and Physiologic Immaturity Of Late-preterm Infmentioning

confidence: 99%

“Late-Preterm” Infants: A Population at Risk

Engle¹,

Tomashek²,

Wallman³

2007

Pediatrics

670

451

View full text Add to dashboard Cite

Late-preterm infants, defined by birth at 34 0 ⁄7 through 36 6 ⁄7 weeks' gestation, are less physiologically and metabolically mature than term infants. Thus, they are at higher risk of morbidity and mortality than term infants. The purpose of this report is to define "late preterm," recommend a change in terminology from "near term" to "late preterm," present the characteristics of late-preterm infants that predispose them to a higher risk of morbidity and mortality than term infants, and propose guidelines for the evaluation and management of these infants after birth.

show abstract

Section: Developmental and Physiologic Immaturity Of Late-preterm Infmentioning

confidence: 99%

“Late-Preterm” Infants: A Population at Risk

Engle¹,

Tomashek²,

Wallman³

2007

Pediatrics

670

451

View full text Add to dashboard Cite

show abstract

“…5,20 The probable cause of this low rate of readmissions is the fact that neonates of low weight or with gestational age < 37 weeks were given phototherapy when levels were ≥ 10 mg/dL, thus avoiding elevated levels of bilirubinemia. This hypothesis is supported by the finding that, of the total number of 80 NB who were readmitted for phototherapy, just nine cases had birth weight < 2,500 g and six had gestational age < 37 weeks, despite such children's elevated risk of hyperbilirubinemia.…”

Section: Discussionmentioning

confidence: 99%

“…This entity, which appeared to have been extinct for years, began to be recognized in a small, but growing number of NB in the USA. [1][2][3][4][5] Early discharge has been associated with significant hyperbilirubinemia, particularly during the first week of life. 5,6 The earlier the discharge, without adequate outpatients follow-up, the greater the probability of more severe jaundice cases going unnoticed by family members, who, in general, are not able to evaluate this complication.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5] Early discharge has been associated with significant hyperbilirubinemia, particularly during the first week of life. 5,6 The earlier the discharge, without adequate outpatients follow-up, the greater the probability of more severe jaundice cases going unnoticed by family members, who, in general, are not able to evaluate this complication. In this manner a small number of neonates will develop very severe hyperbilirubinemia which, if not treated in appropriate time, could result in serious sequelae.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acompanhamento da icterícia neonatal em recém-nascidos de termo e prematuros tardios

Facchini¹,

Mezzacappa²,

Rosa³

et al. 2007

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To report on the results of a project following term and near term newborn infants who were jaundiced during the neonatal period. Methods:Neonates were referred to the follow-up clinic with weight ≥ 2,000 g and/or gestational age ≥ 35 weeks, and jaundice at discharge was initially assessed with an Ingram icterometer or Bilicheck and, if indicated, with a Unistat bilirubinometer (Leica). These newborn infants had bilirubinemia at or above the 40th percentile on the nomogram developed by Bhutani. All infants treated with phototherapy while in hospital were reassessed by laboratory methods 24 hours after withdrawal of treatment. Patients were rehospitalized for intensive phototherapy if their level was greater than or equal to 20 mg/dL. Results:From a total sample of 11,259 neonates, 2,452 (21.8%) were referred to the follow-up clinic, 87.2% (2,140) of whom did return. Eighty returned neonates were readmitted. Return appointments were set for 2,452 patients, 180 (7.3%) of whom had bilirubinemia ≥ 15 mg/dL at discharge. Of these 180, 151 returned for follow-up. Twenty (13.2%) were readmitted for treatment. Of the total number of readmitted patients, two newborn infants had levels ≥ 25 mg/dL and none ≥ 30 mg/dL. All responded rapidly to intensive phototherapy, and there was no need for exchange transfusions. Conclusions:Our results suggest that the regime adopted is effective for detecting and preventing hyperbilirubinemia at risk of causing bilirubin-induced encephalopathy in term and near term newborn infants.J Pediatr (Rio J). 2007;83(4):313-318: Neonatal hyperbilirubinemia/prevention and control, kernicterus/prevention, phototherapy/utilization.

show abstract

“…Dette har medvirket til økende frekvens av reinnleggelser for hyperbilirubinemi (20), som i flere materialer er vist å vaere den hyppigste årsak til reinnleggelse de første leveukene (20,21). Det er derfor viktig å etablere et oppfølgingssystem utenfor sykehus som ivaretar dette aspektet (informasjon til foreldre, opplaering av primaerhelsetjenesten).…”

Section: Lysbehandling Av Fullbårne Barnunclassified

Hyperbilirubinemi hos nyfødte – et kontroversielt tema. Erfaringer med nye indikasjoner for fototerapi og utskiftningstransfusjon

Meberg¹

2009

Nor J Epidemiol

View full text Add to dashboard Cite

Telefon: 33 34 20 00 Telefax: 33 34 39 47 SAMMENDRAGNye indikasjoner for behandling av hyperbilirubinemi hos nyfødte (bilirubinskjema fra Hillingdon sykehus, England) ble innført ved Vestfold sentralsykehus primo 1994. Endringene i panoramaet av behandlingstiltak (lysbehandling, utskiftningstransfusjon) ble registrert i kohortene av levende fødte ved sykehuset i toårsperioden 1994-95 og sammenlignet med foregående treårsperiode 1991-93. Total lysbehandlingsprevalens falt signifikant fra 6,9% av levende fødte i perioden 1991-93 til 5,5% i perioden 1994-95 (p < 0,005). Dette skyldtes helt et betydelig fall i prevalensen av fullbårne barn som ble lysbehandlet for fysiologisk ikterus, fra 4,3% til 1,6% i henholdsvis første og siste periode (p < 0,0005). Prevalensen av barn som ble behandlet for prematuritetshyperbilirubinemi steg signifikant fra 2,0% av levende fødte til 3,2% (p < 0,0005). Dette var delvis forårsaket av en økning i prematuritetsinsidensen, som steg fra 4,5% i perioden 1991-93 til 5,9% i perioden 1994-95 (p < 0,0005). Andelen premature som ble lysbehandlet steg fra 45,2% i første til 53,1% i siste periode (p < 0,05). Prevalensen av blodgruppeimmuniserte barn som ble lysbehandlet var uforandret i de to periodene (henholdsvis 0,6% og 0,7%) (p > 0,05). Det var en markert reduksjon i prevalensen av barn som gjennomgikk utskiftningstransfusjon (fra 0,2 til 0,06% henholdsvis i de to periodene) (p < 0,05). Mulighetene for uheldige psykologiske og biologiske effekter av lysbehandling til friske fullbårne barn med ikterus, reduseres relativt betydelig med de moderate justeringer av indikasjonene som er foretatt. Rutineskiftet har også betydd ressurssparing. På landsbasis vil en slik rutineendring medføre at 1000-2000 fullbårne barn hvert år kan unngå lysbehandling. Indikasjonene for fototerapi og utskiftningstransfusjon for hyperbilirubinemi hos nyfødte i Norge må diskuteres på nytt i lys av ny forskning med tanke på nasjonal konsensus. Kortere liggetider for nyfødte i sykehus etter fødselen gjør det nødvendig med gode rutiner for oppfølging av hyperbilirubinemi utenfor sykehus. ENGLISH SUMMARYNew guidelines for treatment of hyperbilirubinemia in newborn infants (according to a bilirubin chart used at Hillingdon Hospital, England) were introduced at Vestfold Central Hospital primo 1994. Changes in the panorama of interventions (phototherapy, exchange transfusion) were recorded for the two-year period 1994-95 and compared to the preceding three-year period 1991-93. Total prevalence of infants treated by phototherapy declined from 6.9% among those born 1991-93 to 5.5% in those born 1994-95 (p < 0.005). This was entirely caused by a decline in the prevalence of term infants treated for physiological hyperbilirubinemia, from 4.3% in the cohort born 1991-93 to 1.6% in the cohort born 1995-95 (p < 0.0001). The prevalence of preterm infants (gestational age < 37 weeks) treated by phototherapy increased from 2.0% to 3.2% respectively in the two periods (p < 0.0005). This was partly caused by an increase in the prete...

show abstract

The Effect of Early Discharge and Other Factors on Readmission Rates of Newborns

Cited by 93 publications

References 5 publications

“Late-Preterm” Infants: A Population at Risk

“Late-Preterm” Infants: A Population at Risk

Acompanhamento da icterícia neonatal em recém-nascidos de termo e prematuros tardios

Hyperbilirubinemi hos nyfødte – et kontroversielt tema. Erfaringer med nye indikasjoner for fototerapi og utskiftningstransfusjon

Contact Info

Product

Resources

About