Prevalence and Predictors of Back-Transport Closer to Maternal Residence After Acute Neonatal Care in a Regional NICU.
Authors of this article are:
Bourque SL Levek C Melara DL Grover TR Hwang SS.
A summary of the article is shown below:
Objectives To describe the demographics, clinical characteristics and referral patterns of premature infants to a regional level IV neonatal intensive care unit (NICU); to determine the prevalence and predictors of back-transport of infants ≤ 32 weeks gestational age in a level IV NICU; for infants not back-transported closer to maternal residence, determine the length of stay beyond attainment of clinical stability. Methods Data (2010-2014) from the Children’s Hospital Neonatal Database and individual chart review for infants ≤ 32 weeks admitted to a level IV NICU whose maternal residence was outside the metro area were included. Bivariate associations of maternal and infant characteristics with back-transport were estimated using two-sample t tests and Fisher’s exact test. Multivariable logistic regression was used to measure independent predictors of back-transport. Clinical stability was defined as the attainment of full volume enteral feedings and low flow nasal cannula. Results A total of 223 infants were eligible for analysis; of whom 26% were back-transported after acute care. In the adjusted analysis, insurance status, distance from maternal residence and gestational age were significantly associated with back-transport. For infants not back-transported closer to maternal residence, median length of stay in the level IV NICU beyond attainment of clinical stability was 28.5 days. Conclusion for Practice Predictors of back-transport include private insurance, greater distance of maternal residence from NICU and younger gestational age. Many preterm infants admitted to a regional NICU for acute care remained hospitalized in a level IV NICU after achieving clinical stability, for which care in a NICU closer to maternal residence may be appropriate.
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This article is a good source of information and a good way to become familiar with topics such as: Back-transport;Neonatology;Regionalization of care.
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