{"title":"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","authors":"Ryo Itoshima , Venla Ojasalo , Liisa Lehtonen","doi":"10.1016/j.earlhumdev.2024.106016","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>To shorten the hospital stay in preterm infants, it is important to understand the factors extending the length of stay.</p></div><div><h3>Aims</h3><p>To understand how different discharge criteria affect the length of stay in preterm infants.</p></div><div><h3>Study design</h3><p>A retrospective comparison study.</p></div><div><h3>Subjects</h3><p>Preterm infants born at 28 to 31 gestational weeks in 2020–2021 in a Level IV NICU in Japan (<em>n</em> = 22) and a Level III NICU in Finland (<em>n</em> = 49).</p></div><div><h3>Outcome measures</h3><p>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.</p></div><div><h3>Results</h3><p>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; <em>r</em> = 0.58; <em>p</em> < 0.001. The most common last discharge criterion was the family criterion in Japan (<em>n</em> = 19; 86 %) and the respiration criterion in Finland (<em>n</em> = 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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"193 ","pages":"Article 106016"},"PeriodicalIF":2.2000,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378378224000859/pdfft?md5=949915436bf091f4477f6fe0f6dc482c&pid=1-s2.0-S0378378224000859-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Impact of discharge criteria on the length of stay in preterm infants: A retrospective study in Japan and Finland\",\"authors\":\"Ryo Itoshima , Venla Ojasalo , Liisa Lehtonen\",\"doi\":\"10.1016/j.earlhumdev.2024.106016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>To shorten the hospital stay in preterm infants, it is important to understand the factors extending the length of stay.</p></div><div><h3>Aims</h3><p>To understand how different discharge criteria affect the length of stay in preterm infants.</p></div><div><h3>Study design</h3><p>A retrospective comparison study.</p></div><div><h3>Subjects</h3><p>Preterm infants born at 28 to 31 gestational weeks in 2020–2021 in a Level IV NICU in Japan (<em>n</em> = 22) and a Level III NICU in Finland (<em>n</em> = 49).</p></div><div><h3>Outcome measures</h3><p>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.</p></div><div><h3>Results</h3><p>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; <em>r</em> = 0.58; <em>p</em> < 0.001. The most common last discharge criterion was the family criterion in Japan (<em>n</em> = 19; 86 %) and the respiration criterion in Finland (<em>n</em> = 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.</p></div><div><h3>Conclusions</h3><p>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.</p></div>\",\"PeriodicalId\":11435,\"journal\":{\"name\":\"Early human development\",\"volume\":\"193 \",\"pages\":\"Article 106016\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-04-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0378378224000859/pdfft?md5=949915436bf091f4477f6fe0f6dc482c&pid=1-s2.0-S0378378224000859-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Early human development\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0378378224000859\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Early human development","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0378378224000859","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Impact of discharge criteria on the length of stay in preterm infants: A retrospective study in Japan and Finland
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.
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.
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