Impact of discharge criteria on the length of stay in preterm infants: A retrospective study in Japan and Finland

IF 2.2 3区医学 Q2 OBSTETRICS & GYNECOLOGY Early human development Pub Date : 2024-04-21 DOI:10.1016/j.earlhumdev.2024.106016

Ryo Itoshima , Venla Ojasalo , Liisa Lehtonen

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Abstract

Background

To shorten the hospital stay in preterm infants, it is important to understand the factors extending the length of stay.

Aims

To understand how different discharge criteria affect the length of stay in preterm infants.

Study design

A retrospective comparison study.

Subjects

Preterm infants born at 28 to 31 gestational weeks in 2020–2021 in a Level IV NICU in Japan (n = 22) and a Level III NICU in Finland (n = 49).

Outcome measures

We compared the most common last discharge criteria and the postmenstrual age (PMA) between the two NICUs. The potential extending effects of each discharge criterion on the length of stay were also evaluated. The discharge criteria were classified into six categories: temperature, respiration, feeding, examination, weight limit, and family readiness.

Results

The PMA at discharge was significantly higher in Japan than in Finland: median 40.7 (interquartile range 39.9–41.3) vs. 37.9 (36.9–39.0) weeks; r = 0.58; p < 0.001. The most common last discharge criterion was the family criterion in Japan (n = 19; 86 %) and the respiration criterion in Finland (n = 43; 88 %). In Japan, the length of stay was extended by 7.9 (standard deviation [SD] 7.0) days due to a lack of family readiness for discharge and 8.7 (SD 8.7) days due to not having discharged home with a feeding tube as a common practice.

Conclusions

The length of stay of preterm infants in Japan could be notably reduced by supporting the parents' earlier readiness for discharge and allowing tube feeding at home.

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出院标准对早产儿住院时间的影响：日本和芬兰的回顾性研究

背景为了缩短早产儿的住院时间，了解延长住院时间的因素非常重要。目的了解不同的出院标准如何影响早产儿的住院时间。研究对象2020-2021年间在日本四级新生儿重症监护病房（22人）和芬兰三级新生儿重症监护病房（49人）出生的孕周在28-31周的早产儿.结果测量我们比较了两家新生儿重症监护病房最常见的最后出院标准和月经后年龄（PMA）。我们还评估了每种出院标准对住院时间的潜在延伸效应。出院标准分为六类：体温、呼吸、喂养、检查、体重限制和家属准备情况。结果日本新生儿出院时的月经后年龄（PMA）明显高于芬兰：中位数为 40.7 周（四分位距为 39.9-41.3 周），芬兰为 37.9 周（36.9-39.0 周）；r = 0.58；p <0.001。在日本，最常见的最后出院标准是家属标准（19 人；86%），在芬兰则是呼吸标准（43 人；88%）。在日本，由于家属没有做好出院准备，住院时间延长了 7.9 天（标准差 [SD] 7.0），而由于没有按照惯例在出院回家时插管喂养，住院时间延长了 8.7 天（标准差 8.7）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Early human development 医学-妇产科学

CiteScore

4.40

自引率

4.00%

发文量

100

审稿时长

46 days

期刊介绍： Established as an authoritative, highly cited voice on early human development, Early Human Development provides a unique opportunity for researchers and clinicians to bridge the communication gap between disciplines. Creating a forum for the productive exchange of ideas concerning early human growth and development, the journal publishes original research and clinical papers with particular emphasis on the continuum between fetal life and the perinatal period; aspects of postnatal growth influenced by early events; and the safeguarding of the quality of human survival. The first comprehensive and interdisciplinary journal in this area of growing importance, Early Human Development offers pertinent contributions to the following subject areas: Fetology; perinatology; pediatrics; growth and development; obstetrics; reproduction and fertility; epidemiology; behavioural sciences; nutrition and metabolism; teratology; neurology; brain biology; developmental psychology and screening.