Intensive care unit readmission during childhood after preterm birth with respiratory failure

Peter M. Mourani, John P. Kinsella, Gilles Clermont, Lan Kong, Amy M. Perkins, Lisa Weissfeld, Gary Cutter, Walter T. Linde-Zwirble, Steven H. Abman, Derek C. Angus, R. Scott Watson

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective To determine the incidence and risk factors for readmission to the intensive care unit (ICU) among preterm infants who required mechanical ventilation at birth. Study design We studied preterm newborns (birth weight 500-1250 g) who required mechanical ventilation at birth and were enrolled in a multicenter trial of inhaled nitric oxide therapy. Patients were assessed up to 4.5 years of age via annual in-person evaluations and structured telephone interviews. Univariate and multivariable analyses of baseline and birth hospitalization predictors of ICU readmission were performed. Results Of 512 subjects providing follow-up data, 58% were readmitted to the hospital (51% of these had multiple readmissions, averaging 3.9 readmissions per subject), 19% were readmitted to an ICU, and 12% required additional mechanical ventilation support. In univariate analyses, ICU readmission was more common among male subjects (OR 2.01; 95% CI 1.27-3.18), infants with grade 3-4 intracranial hemorrhage (OR 2.13; 95% CI 1.23-3.69), increasing duration of birth hospitalization (OR 1.01 per day; 95% CI 1.00-1.02), and prolonged oxygen therapy (OR 1.01 per day; 95% CI 1.00-1.01). In the first year after birth hospitalization, children readmitted to an ICU incurred greater health care costs (median $69 700 vs $30 200 for subjects admitted to the ward and $9600 for subjects never admitted). Conclusions Small preterm infants who were mechanically ventilated at birth have substantial risk for readmission to an ICU and late mechanical ventilation, require extensive health care resources, and incur high treatment costs.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume164
Issue number4
DOIs
StatePublished - Jan 1 2014

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Premature Birth
Respiratory Insufficiency
Intensive Care Units
Parturition
Artificial Respiration
Hospitalization
Premature Infants
Health Care Costs
Intracranial Hemorrhages
Health Resources
Birth Weight
Multicenter Studies
Nitric Oxide
Newborn Infant
Interviews
Oxygen
Delivery of Health Care
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Mourani, P. M., Kinsella, J. P., Clermont, G., Kong, L., Perkins, A. M., Weissfeld, L., ... Watson, R. S. (2014). Intensive care unit readmission during childhood after preterm birth with respiratory failure. Journal of Pediatrics, 164(4). https://doi.org/10.1016/j.jpeds.2013.11.062
Mourani, Peter M. ; Kinsella, John P. ; Clermont, Gilles ; Kong, Lan ; Perkins, Amy M. ; Weissfeld, Lisa ; Cutter, Gary ; Linde-Zwirble, Walter T. ; Abman, Steven H. ; Angus, Derek C. ; Watson, R. Scott. / Intensive care unit readmission during childhood after preterm birth with respiratory failure. In: Journal of Pediatrics. 2014 ; Vol. 164, No. 4.
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abstract = "Objective To determine the incidence and risk factors for readmission to the intensive care unit (ICU) among preterm infants who required mechanical ventilation at birth. Study design We studied preterm newborns (birth weight 500-1250 g) who required mechanical ventilation at birth and were enrolled in a multicenter trial of inhaled nitric oxide therapy. Patients were assessed up to 4.5 years of age via annual in-person evaluations and structured telephone interviews. Univariate and multivariable analyses of baseline and birth hospitalization predictors of ICU readmission were performed. Results Of 512 subjects providing follow-up data, 58{\%} were readmitted to the hospital (51{\%} of these had multiple readmissions, averaging 3.9 readmissions per subject), 19{\%} were readmitted to an ICU, and 12{\%} required additional mechanical ventilation support. In univariate analyses, ICU readmission was more common among male subjects (OR 2.01; 95{\%} CI 1.27-3.18), infants with grade 3-4 intracranial hemorrhage (OR 2.13; 95{\%} CI 1.23-3.69), increasing duration of birth hospitalization (OR 1.01 per day; 95{\%} CI 1.00-1.02), and prolonged oxygen therapy (OR 1.01 per day; 95{\%} CI 1.00-1.01). In the first year after birth hospitalization, children readmitted to an ICU incurred greater health care costs (median $69 700 vs $30 200 for subjects admitted to the ward and $9600 for subjects never admitted). Conclusions Small preterm infants who were mechanically ventilated at birth have substantial risk for readmission to an ICU and late mechanical ventilation, require extensive health care resources, and incur high treatment costs.",
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Mourani, PM, Kinsella, JP, Clermont, G, Kong, L, Perkins, AM, Weissfeld, L, Cutter, G, Linde-Zwirble, WT, Abman, SH, Angus, DC & Watson, RS 2014, 'Intensive care unit readmission during childhood after preterm birth with respiratory failure', Journal of Pediatrics, vol. 164, no. 4. https://doi.org/10.1016/j.jpeds.2013.11.062

Intensive care unit readmission during childhood after preterm birth with respiratory failure. / Mourani, Peter M.; Kinsella, John P.; Clermont, Gilles; Kong, Lan; Perkins, Amy M.; Weissfeld, Lisa; Cutter, Gary; Linde-Zwirble, Walter T.; Abman, Steven H.; Angus, Derek C.; Watson, R. Scott.

In: Journal of Pediatrics, Vol. 164, No. 4, 01.01.2014.

Research output: Contribution to journalArticle

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T1 - Intensive care unit readmission during childhood after preterm birth with respiratory failure

AU - Mourani, Peter M.

AU - Kinsella, John P.

AU - Clermont, Gilles

AU - Kong, Lan

AU - Perkins, Amy M.

AU - Weissfeld, Lisa

AU - Cutter, Gary

AU - Linde-Zwirble, Walter T.

AU - Abman, Steven H.

AU - Angus, Derek C.

AU - Watson, R. Scott

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective To determine the incidence and risk factors for readmission to the intensive care unit (ICU) among preterm infants who required mechanical ventilation at birth. Study design We studied preterm newborns (birth weight 500-1250 g) who required mechanical ventilation at birth and were enrolled in a multicenter trial of inhaled nitric oxide therapy. Patients were assessed up to 4.5 years of age via annual in-person evaluations and structured telephone interviews. Univariate and multivariable analyses of baseline and birth hospitalization predictors of ICU readmission were performed. Results Of 512 subjects providing follow-up data, 58% were readmitted to the hospital (51% of these had multiple readmissions, averaging 3.9 readmissions per subject), 19% were readmitted to an ICU, and 12% required additional mechanical ventilation support. In univariate analyses, ICU readmission was more common among male subjects (OR 2.01; 95% CI 1.27-3.18), infants with grade 3-4 intracranial hemorrhage (OR 2.13; 95% CI 1.23-3.69), increasing duration of birth hospitalization (OR 1.01 per day; 95% CI 1.00-1.02), and prolonged oxygen therapy (OR 1.01 per day; 95% CI 1.00-1.01). In the first year after birth hospitalization, children readmitted to an ICU incurred greater health care costs (median $69 700 vs $30 200 for subjects admitted to the ward and $9600 for subjects never admitted). Conclusions Small preterm infants who were mechanically ventilated at birth have substantial risk for readmission to an ICU and late mechanical ventilation, require extensive health care resources, and incur high treatment costs.

AB - Objective To determine the incidence and risk factors for readmission to the intensive care unit (ICU) among preterm infants who required mechanical ventilation at birth. Study design We studied preterm newborns (birth weight 500-1250 g) who required mechanical ventilation at birth and were enrolled in a multicenter trial of inhaled nitric oxide therapy. Patients were assessed up to 4.5 years of age via annual in-person evaluations and structured telephone interviews. Univariate and multivariable analyses of baseline and birth hospitalization predictors of ICU readmission were performed. Results Of 512 subjects providing follow-up data, 58% were readmitted to the hospital (51% of these had multiple readmissions, averaging 3.9 readmissions per subject), 19% were readmitted to an ICU, and 12% required additional mechanical ventilation support. In univariate analyses, ICU readmission was more common among male subjects (OR 2.01; 95% CI 1.27-3.18), infants with grade 3-4 intracranial hemorrhage (OR 2.13; 95% CI 1.23-3.69), increasing duration of birth hospitalization (OR 1.01 per day; 95% CI 1.00-1.02), and prolonged oxygen therapy (OR 1.01 per day; 95% CI 1.00-1.01). In the first year after birth hospitalization, children readmitted to an ICU incurred greater health care costs (median $69 700 vs $30 200 for subjects admitted to the ward and $9600 for subjects never admitted). Conclusions Small preterm infants who were mechanically ventilated at birth have substantial risk for readmission to an ICU and late mechanical ventilation, require extensive health care resources, and incur high treatment costs.

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