Joanne Lagatta1, Karna Murthy2, Isabella Zaniletti3, Stephanie Bourque4, William Engle5, Rebecca Rose5, Namasivayam Ambalavanan6, David Brousseau7. 1. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI. Electronic address: jlagatta@mcw.edu. 2. Department of Pediatrics, Northwestern University, Chicago, IL. 3. Children's Hospitals Association, Lenexa, KS. 4. Department of Pediatrics, University of Colorado, Aurora, CO. 5. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN. 6. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. 7. Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
Abstract
OBJECTIVE: To determine associations between home oxygen use and 1-year readmissions for preterm infants with bronchopulmonary dysplasia (BPD) discharged from regional neonatal intensive care units. STUDY DESIGN: We performed a secondary analysis of the Children's Hospitals Neonatal Database, with readmission data via the Pediatric Hospital Information System and demographics using ZIP-code-linked census data. We included infants born <32 weeks of gestation with BPD, excluding those with anomalies and tracheostomies. Our primary outcome was readmission by 1 year corrected age; secondary outcomes included readmission duration, mortality, and readmission diagnosis-related group codes. A staged multivariable logistic regression was adjusted for center, clinical, and social risk factors; at each stage we included variables associated at P < .1 in bivariable analysis with home oxygen use or readmission. RESULTS: Home oxygen was used in 1906 of 3574 infants (53%) in 22 neonatal intensive care units. Readmission occurred in 34%. Earlier gestational age, male sex, gastrostomy tube, surgical necrotizing enterocolitis, lower median income, nonprivate insurance, and shorter hospital-to-home distance were associated with readmission. Home oxygen was not associated with odds of readmission (OR, 1.2; 95% CI, 0.98-1.56), readmission duration, or mortality. Readmissions for infants with home oxygen were more often coded as BPD (16% vs 4%); readmissions for infants on room air were more often gastrointestinal (29% vs 22%; P < .001). Clinical risk factors explained 72% of center variance in readmission. CONCLUSIONS: Home oxygen use is not associated with readmission for infants with BPD in regional neonatal intensive care units. Center variation in home oxygen use does not impact readmission risk. Nonrespiratory problems are important contributors to readmission risk for infants with BPD.
OBJECTIVE: To determine associations between home oxygen use and 1-year readmissions for preterm infants with bronchopulmonary dysplasia (BPD) discharged from regional neonatal intensive care units. STUDY DESIGN: We performed a secondary analysis of the Children's Hospitals Neonatal Database, with readmission data via the Pediatric Hospital Information System and demographics using ZIP-code-linked census data. We included infants born <32 weeks of gestation with BPD, excluding those with anomalies and tracheostomies. Our primary outcome was readmission by 1 year corrected age; secondary outcomes included readmission duration, mortality, and readmission diagnosis-related group codes. A staged multivariable logistic regression was adjusted for center, clinical, and social risk factors; at each stage we included variables associated at P < .1 in bivariable analysis with home oxygen use or readmission. RESULTS: Home oxygen was used in 1906 of 3574 infants (53%) in 22 neonatal intensive care units. Readmission occurred in 34%. Earlier gestational age, male sex, gastrostomy tube, surgical necrotizing enterocolitis, lower median income, nonprivate insurance, and shorter hospital-to-home distance were associated with readmission. Home oxygen was not associated with odds of readmission (OR, 1.2; 95% CI, 0.98-1.56), readmission duration, or mortality. Readmissions for infants with home oxygen were more often coded as BPD (16% vs 4%); readmissions for infants on room air were more often gastrointestinal (29% vs 22%; P < .001). Clinical risk factors explained 72% of center variance in readmission. CONCLUSIONS: Home oxygen use is not associated with readmission for infants with BPD in regional neonatal intensive care units. Center variation in home oxygen use does not impact readmission risk. Nonrespiratory problems are important contributors to readmission risk for infants with BPD.
Authors: I M Balfour-Lynn; D J Field; P Gringras; B Hicks; E Jardine; R C Jones; A G Magee; R A Primhak; M P Samuels; N J Shaw; S Stevens; C Sullivan; J A Taylor; C Wallis Journal: Thorax Date: 2009-08 Impact factor: 9.139
Authors: Roberta L Keller; Rui Feng; Sara B DeMauro; Thomas Ferkol; William Hardie; Elizabeth E Rogers; Timothy P Stevens; Judith A Voynow; Scarlett L Bellamy; Pamela A Shaw; Paul E Moore Journal: J Pediatr Date: 2017-05-17 Impact factor: 4.406
Authors: K Murthy; E K Pallotto; J Gien; B S Brozanski; N F M Porta; I Zaniletti; S Keene; L G Chicoine; N E Rintoul; F D Dykes; J M Asselin; B L Short; M A Padula; D J Durand; K M Reber; J R Evans; T R Grover Journal: J Perinatol Date: 2016-03-10 Impact factor: 2.521
Authors: Vincent C Smith; John A F Zupancic; Marie C McCormick; Lisa A Croen; John Greene; Gabriel J Escobar; Douglas K Richardson Journal: J Pediatr Date: 2004-06 Impact factor: 4.406
Authors: An N Massaro; Karna Murthy; Isabella Zaniletti; Noah Cook; Robert DiGeronimo; Maria L V Dizon; Shannon E G Hamrick; Victor J McKay; Girija Natarajan; Rakesh Rao; Troy Richardson; Danielle Smith; Amit M Mathur Journal: J Pediatr Date: 2016-03-16 Impact factor: 4.406
Authors: Erik A Jensen; Kevin Dysart; Marie G Gantz; Scott McDonald; Nicolas A Bamat; Martin Keszler; Haresh Kirpalani; Matthew M Laughon; Brenda B Poindexter; Andrea F Duncan; Bradley A Yoder; Eric C Eichenwald; Sara B DeMauro Journal: Am J Respir Crit Care Med Date: 2019-09-15 Impact factor: 21.405
Authors: Don Hayes; Kevin C Wilson; Katelyn Krivchenia; Stephen M M Hawkins; Ian M Balfour-Lynn; David Gozal; Howard B Panitch; Mark L Splaingard; Lawrence M Rhein; Geoffrey Kurland; Steven H Abman; Timothy M Hoffman; Christopher L Carroll; Mary E Cataletto; Dmitry Tumin; Eyal Oren; Richard J Martin; Joyce Baker; Gregory R Porta; Deborah Kaley; Ann Gettys; Robin R Deterding Journal: Am J Respir Crit Care Med Date: 2019-02-01 Impact factor: 21.405
Authors: Laura H Rubinos; Carolyn C Foster; Kerri Z Machut; Alexis Snyder; Eddie Simpser; Matt Hall; Elizabeth Casto; Jay G Berry Journal: J Perinatol Date: 2021-11-23 Impact factor: 2.521
Authors: Emma Banwell; Joseph M Collaco; Gabriela R Oates; Jessica L Rice; Lucia D Juarez; Lisa R Young; Sharon A McGrath-Morrow Journal: Pediatr Pulmonol Date: 2022-05-21
Authors: Joseph M Collaco; Michael C Tracy; Catherine A Sheils; Jessica L Rice; Lawrence M Rhein; Leif D Nelin; Paul E Moore; Winston M Manimtim; Jonathan C Levin; Khanh Lai; Lystra P Hayden; Julie L Fierro; Eric D Austin; Stamatia Alexiou; Amit Agarwal; Natalie Villafranco; Roopa Siddaiah; Antonia P Popova; Ioana A Cristea; Christopher D Baker; Manvi Bansal; Sharon A McGrath-Morrow Journal: Pediatr Pulmonol Date: 2022-04-26
Authors: Joseph M Collaco; Brianna C Aoyama; Jessica L Rice; Sharon A McGrath-Morrow Journal: Expert Rev Respir Med Date: 2021-06-17 Impact factor: 3.772