Length of postnatal stay in healthy newborns and re-hospitalization following their early discharge
Length of postnatal stay in healthy newborns and re-hospitalization following their early discharge
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DOI：
10.1007/bf02859282
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发表时间：
2006-10-01
影响因子：
4.3
通讯作者：
Dua, Tarun
中科院分区：
文献类型：
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作者：
Gupta, Piyush;Malhotra, Saurabh;Dua, Tarun
objective.本研究前瞻性地进行，以确定i）健康新生儿的产后住院时间长度，并确定促进其提前出院（<48 h）的因素; ii）在三级护理医院，提前出院后再次住院的频率和原因。记录健康新生儿的住院时间。通过单变量和多变量（多元logistic回归）分析确定促进早期出院的因素。在48 h内出院的新生儿中，每3例均在72 h后进行随访，检查是否存在任何医疗问题和是否需要再次住院。共有1134名婴儿入组，其中861名（76.2%）在48小时或之前出院。总体平均（SD）住院时间为46.4（45.8）h。导致早期排出的因素包括阴道分娩（RR：30.2; 95% CI：19.0，47.9; P <0.001），无既存母体疾病或产科并发症（FIR：4.32; 95%Cl：2.27，8.22; P <0.001），并且出生体重> 2.5kg（FIR：1.91; 95%Cl：1.27，2.89; P = 0.002）。在要求随访的280例新生儿中，报告了193例。其中61例（31.6%）正常。新生儿黄疸是最常见的问题，在105（54.4%）的儿童随访。仅16例（8.3%）新生儿需再次住院，最常见的指征为新生儿黄疸（n = 9）。我们机构中的大多数儿童都在48小时内出院。提前出院主要取决于产妇的适应症。72小时后的随访对于评估出生后48小时内出院的健康新生儿是否需要再次住院非常重要。
Objective. The present study was conducted prospectively to determine i) the length of postnatal hospital stay of healthy newborns and determine the factors facilitating their early discharge (< 48 h) and ii) the frequency and causes of re-hospitalization following early discharge, in a tertiary care hospital.Methods. Length of hospital stay was recorded for healthy newborns. Factors facilitating Early discharge were determined by both univariate and multivariate (multiple logistic regression) analyses. Of all newborns discharged within 48 h, every third case was called for a follow-up visit 72 hrs later and examined for any medical problem and need of re-hospitalization.Results. A total of 1134 babies were enrolled, of which 861 (76.2%) were discharged at or before 48 hours. The overall mean (SD) length of hospital stay was 46.4 (45.8) h. Factors contributing to early discharge included vaginal delivery (RR: 30.2; 95% Cl: 19.0, 47.9; P < 0.001), absence of pre-existing maternal disease or obstetric complication (FIR: 4.32; 95% Cl: 2.27, 8.22; P < 0.001), and birth weight of > 2.5 kg (FIR: 1.91; 95% Cl: 1.27, 2.89; P = 0.002). Of the 280 neonates called for follow-up, 193 reported. Of these, 61 (31.6%) were normal. Neonatal jaundice was the most frequent problem seen in 105 (54.4%) children on follow-up. Only 16 (8.3%) newborns needed re-hospitalization; the most common indication being neonatal jaundice (n=9).Conclusion. Most of the children in our set-up are being discharged within 48 hrs. Early discharge is governed primarily by maternal indications. A follow-up visit after 72 hr is important to assess the need of re-hospitalization in healthy newborns discharged within 48 hrs of birth.