Incidence, Risk Factors, and Reasons for 30-Day Hospital Readmission Among Healthy Late Preterm Infants.
Incidence, Risk Factors, and Reasons for 30-Day Hospital Readmission Among Healthy Late Preterm Infants.
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DOI：
10.1542/hpeds.2021-006215
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发表时间：
2022-07-01
影响因子：
--
通讯作者：
Jelliffe-Pawlowski, Laura
中科院分区：
文献类型：
--
作者：
Amsalu, Ribka;Oltman, Scott P.;Baer, Rebecca J.;Medvedev, Melissa M.;Rogers, Elizabeth E.;Jelliffe-Pawlowski, Laura
与足月儿相比，晚期早产儿发病的风险更高。我们试图确定30天再入院的比率、时间趋势、危险因素和原因。这是一项对2011年1月1日至2017年12月31日期间在加利福尼亚州怀孕34至42周出生的婴儿的回顾性队列研究。加州生命统计局保存的出生证明与加州全州卫生规划和发展办公室维护的出院记录有关。采用多变量Logistic回归分析确定危险因素并建立预测模型。晚期早产儿占研究队列(n=122014)的4.3%(n=2824963)，其中5.9%(n=7243)在30天内再次入院。与足月儿相比，晚期早产儿再次入院的几率更大(优势比[OR]：2.34[95%可信区间：2.28-2.40])。时间趋势显示全因和特定于黄疸的再入院儿增加(P<；.001)。再次入院时常见的诊断为黄疸(58.9%)、感染(10.8%)和呼吸道并发症(3.5%)。在调整后的模型中，与较大再入院几率相关的因素包括助产、产妇年龄≥34岁、糖尿病、绒毛膜羊膜炎和初产。该模型对出生时住院天数为5天的晚期早产儿有60%的预测能力(c-统计0.603[95%CI：0.596-0.610])。这些发现有助于了解哪些因素会增加或降低重新入院的风险。需要进行纵向研究，以检验医院出院前和后续护理实践的前景。
Late preterm infants have an increased risk of morbidity relative to term infants. We sought to determine the rate, temporal trend, risk factors, and reasons for 30-day readmission. This is a retrospective cohort study of infants born at 34 to 42 weeks’ gestation in California between January 1, 2011, and December 31, 2017. Birth certificates maintained by California Vital Statistics were linked to discharge records maintained by the California Office of Statewide Health Planning and Development. Multivariable logistic regression was used to identify risk factors and derive a predictive model. Late preterm infants represented 4.3% (n = 122014) of the study cohort (n = 2824963), of which 5.9% (n = 7243) were readmitted within 30 days. Compared to term infants, late preterm infants had greater odds of readmission (odds ratio [OR]: 2.34 [95% confidence interval (CI): 2.28–2.40]). The temporal trend indicated increases in all-cause and jaundice-specific readmission infants (P < .001). The common diagnoses at readmission were jaundice (58.9%), infections (10.8%), and respiratory complications (3.5%). In the adjusted model, factors that were associated with greater odds of readmission included assisted vaginal birth, maternal age ≥34 years, diabetes, chorioamnionitis, and primiparity. The model had predictive ability of 60% (c-statistic 0.603 [95% CI: 0.596–0.610]) in late preterm infants who had <5 days length of stay at birth. The findings contribute important information on what factors increase or decrease the risk of readmission. Longitudinal studies are needed to examine promising hospital predischarge and follow-up care practices.
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影响因子：
8
作者：
Reddy UM;Ko CW;Raju TN;Willinger M
通讯作者：
Willinger M
影响因子：
158.5
作者：
Madden, JM;Soumerai, SB;Ross-Degnan, D
通讯作者：
Ross-Degnan, D
影响因子：
3.4
作者：
Escobar, GJ;Clark, RH;Greene, JD
通讯作者：
Greene, JD
影响因子：
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作者：
Burgos, Anthony E.;Schmitt, Susan K.;Phibbs, Ciaran S.
通讯作者：
Phibbs, Ciaran S.
影响因子：
12.7
作者：
KOTELCHUCK, M
通讯作者：
KOTELCHUCK, M