Abstract
Objective: Ensuring cardiorespiratory (CR) stability is essential for a safe discharge. The aim of this study was to assess the impact of a new pre-discharge protocol named CORE on the risk of hospital readmission (RHR).Methods: Preterm infants admitted in our NICU between 2015 and 2018 were randomly assigned to CORE (exposed) or to standard (not-exposed) discharge protocol. CORE included 24 h-clinical observation, followed by 24 h-instrumental CR monitoring only for high-risk infants. RHR 12 months after discharge and length of stay represent the primary and secondary outcomes, respectively.Results: Three hundred and twenty three preterm infants were enrolled. Exposed infants had a lower RHR (log-rank p < 0.05). The difference was especially marked 3 months after discharge (9.09 vs. 21.6%; p = 0.004). The hospital length of stay in exposed and not-exposed infants was 39(26–58) and 43(26–68) days, respectively (p = 0.16).Conclusions: The CORE protocol could help neonatologists to define the best timing for discharge reducing RHR without lengthening hospital stay.
Highlights
Preterm birth is the most important determinant of adverse infant outcomes in terms of survival and short and long-term health complications affecting quality of life [1]
The Cardio Observation and Respiratory Evaluation (CORE) protocol could help neonatologists to define the best timing for discharge reducing risk of hospital readmission (RHR) without lengthening hospital stay
Especially those born with a very low birth weight (VLBW), are more likely to suffer from major morbidity such as respiratory distress and subsequent bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, persistent patent ductus arteriosus, and sepsis and are at higher risk of mortality than infants born at term [2,3,4,5,6,7,8]
Summary
Preterm birth is the most important determinant of adverse infant outcomes in terms of survival and short and long-term health complications affecting quality of life [1]. Preterm infants, especially those born with a very low birth weight (VLBW), are more likely to suffer from major morbidity such as respiratory distress and subsequent bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, persistent patent ductus arteriosus, and sepsis and are at higher risk of mortality than infants born at term [2,3,4,5,6,7,8]. The decision to discharge is primarily based on the infant’s medical status (demonstration of functional maturation including physiological competencies of thermoregulation, control of breathing, respiratory stability, feeding skills, and weight gain) but its success, including avoiding early admission to
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