Barriers to screening infants for retinopathy of prematurity after discharge or transfer from a neonatal intensive care unit.
Barriers to screening infants for retinopathy of prematurity after discharge or transfer from a neonatal intensive care unit.
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DOI：
10.1038/sj.jp.7211203
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发表时间：
2005-01-01
期刊：
影响因子：
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通讯作者：
Bratton, Susan L
中科院分区：
文献类型：
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作者：
Attar, Mohammad A;Gates, Molly R;Bratton, Susan L
目的：评估影响早产儿视网膜病变（ROP）筛查和随访的新生儿重症监护室（NICU）实践。方法：回顾性研究1999年1月1日至2002年5月31日期间入住地区NICU的有ROP风险、有资格背部转运的婴儿。患者出院后或从新生儿重症监护室转移，如果我们不能验证他们的ROP筛选后续1 months.RESULTS：共74名婴儿被确定为需要后续的眼睛护理后，没有得到所需的后续ROP。与接受推荐护理的婴儿相比，未接受随访护理的婴儿的平均胎龄（平均SD; 30.7 ± 2.3 vs 29.6 ± 2.5周，p=0.05）和出生体重（平均SD; 1581 ± 366 vs 1360 ± 508 g，p=0.007）更大。与从区域中心出院的婴儿相比，运回社区医院的婴儿更有可能错过后续眼科护理（相对风险2.81，95%置信区间（CI）（1.09至7.20））。在新生儿重症监护室未筛查ROP的婴儿与在新生儿重症监护室进行首次视网膜检查的婴儿相比，有更大的风险错过后续护理（相对风险4.25，95%CI（1.42至12.73））。结论：在ROP筛查前从新生儿重症监护室转回或出院的婴儿是未接受后续眼科护理的高风险人群。
OBJECTIVE: To assess neonatal intensive care unit (NICU) practices affecting screening and follow-up for retinopathy of prematurity (ROP).METHODS: Retrospective study of infants at risk for ROP, eligible for back transport, admitted to a regional NICU from January 1, 1999 until May 31, 2002. Patients failed to receive needed follow-up for ROP after discharge or transfer from a NICU, if we could not verify their ROP screening follow-up within 1 month.RESULTS: A total of 74 infants were identified to need follow-up eye care. Infants who did not receive the follow-up care had greater mean gestational age (mean SD; 30.7+/-2.3 vs 29.6+/-2.5 weeks, p=0.05) and birth weights (mean SD; 1581+/-366 vs 1360+/-508 g, p=0.007), compared to infants who received the recommended care. Infants transported back to the community hospital were significantly more likely to miss follow-up eye care compared to infants discharged from the regional center (relative risk 2.81, 95% confidence interval (CI) (1.09 to 7.20)). Infants not screened for ROP in the NICU had greater risk for missing follow-up care compared to infants who had their first retinal examination in the NICU (relative risk 4.25, 95% CI (1.42 to 12.73)).CONCLUSIONS: Infants transferred back or discharged from the NICU before ROP screening represent a high-risk group for not receiving follow-up eye care.