Srinivas Murki1, Venkateshwarlu Vardhelli1, Saikiran Deshabhotla1, Deepak Sharma1, Dinesh Pawale1, Dattatray Kulkarni1, Praveen Kumar2, Nandkishor S Kabra3, Mangalabharathi Sundaram4, Nishad Plakkal5, Ashish Mehta6, Baswaraj Tandur7, Deepak Chawla8, Subramanian Sreeram9, Bijan Saha10, P N Suman Rao11, Sandeep Kadam12. 1. Department of Neonatology, Fernandez Hospital, Hyderabad, India. 2. Department of Neonatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 3. Department of Neonatology, Surya Mother and Child Care super speciality Hospital, Mumbai, India. 4. Department of Neonatology, Institute of Child Health and Hospital for Children, Chennai, India. 5. Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India. 6. Department of Neonatology, Arpan Hospital, Ahmedabad, India. 7. Department of Neonatology, Vijaya Marie Hospital, Hyderabad, India. 8. Department of Neonatology, Government Medical College, Chandigarh, India. 9. Department of Neonatology, Paramitha Children Hospital, Hyderabad, India. 10. Department of Neonatology, SSKM Hospital, Kolkata, India. 11. Department of Neonatology, St John's Medical College, Bengaluru, India. 12. Department of Neonatology, Ratna Memorial hospital, Pune, India.
Abstract
AIM: Prediction of length of stay (LOS) among preterm neonates is important for counselling of parents and for assessing neonatal intensive care unit (NICU) census and economic burden. The aim of this study is to evaluate perinatal and postnatal factors that influence LOS in preterm infants (25-33 weeks of gestation) admitted to participating NICUs of Indian National Neonatal Collaborative (INNC). METHODS: From the INNC database, the data which were prospectively entered using uniformed pre-defined criteria were analysed. RESULTS: A total of 3095 infants were included from 12 centres. Every week decrease in gestation increased LOS by 9 days. The median LOS for infants with gestational age of 25, 26, 27, 28, 29, 30, 31, 32 and 33 weeks were 86, 70, 62, 52, 40, 30, 23, 16 and 10 days, respectively. On multivariate analysis, abnormal antenatal umbilical artery doppler, severe small for gestational age (SGA), requirement of resuscitation, respiratory distress syndrome (RDS), seizures, sepsis, necrotising enterocolitis (NEC), major malformations and bronchopulmonary dysplasia (BPD) increased LOS by 5.4 (3.5-7.4), 21.6 (19-23.9), 4.7 (3.3-6.1), 3 (1.7-4.3), 15.2 (8.5-22.1), 11.2 (9.1-13.2), 9.8 (5.2-14.4), 8.8 (4.4-13.3) and 5.6 (0.5-10.7) days, respectively. CONCLUSIONS: Apart from lower gestation and birth weight, abnormal antenatal umbilical artery doppler, severe SGA, resuscitation need, major malformations, RDS, seizures, sepsis, NEC and BPD influenced LOS in preterm infants. In comparison with other networks or data from developed countries, LOS in our network was comparatively less for similar gestational age infants.
AIM: Prediction of length of stay (LOS) among preterm neonates is important for counselling of parents and for assessing neonatal intensive care unit (NICU) census and economic burden. The aim of this study is to evaluate perinatal and postnatal factors that influence LOS in preterm infants (25-33 weeks of gestation) admitted to participating NICUs of Indian National Neonatal Collaborative (INNC). METHODS: From the INNC database, the data which were prospectively entered using uniformed pre-defined criteria were analysed. RESULTS: A total of 3095 infants were included from 12 centres. Every week decrease in gestation increased LOS by 9 days. The median LOS for infants with gestational age of 25, 26, 27, 28, 29, 30, 31, 32 and 33 weeks were 86, 70, 62, 52, 40, 30, 23, 16 and 10 days, respectively. On multivariate analysis, abnormal antenatal umbilical artery doppler, severe small for gestational age (SGA), requirement of resuscitation, respiratory distress syndrome (RDS), seizures, sepsis, necrotising enterocolitis (NEC), major malformations and bronchopulmonary dysplasia (BPD) increased LOS by 5.4 (3.5-7.4), 21.6 (19-23.9), 4.7 (3.3-6.1), 3 (1.7-4.3), 15.2 (8.5-22.1), 11.2 (9.1-13.2), 9.8 (5.2-14.4), 8.8 (4.4-13.3) and 5.6 (0.5-10.7) days, respectively. CONCLUSIONS: Apart from lower gestation and birth weight, abnormal antenatal umbilical artery doppler, severe SGA, resuscitation need, major malformations, RDS, seizures, sepsis, NEC and BPD influenced LOS in preterm infants. In comparison with other networks or data from developed countries, LOS in our network was comparatively less for similar gestational age infants.