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Center variability in risk of adjusted length of stay for very low birth weight infants in the Neocosur South American Network.


Marshall G1, Luque MJ, Gonzalez A, D'Apremont I, Musante G, Tapia JL.
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  • 1Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Província de Santiago, Chile.


J Pediatr (Rio J). 2012 Nov-Dec;88(6):524-30.doi:10.2223/JPED.2234.



OBJECTIVES: To develop a prediction model for hospital length of stay (LOS) in very low birth weight (VLBW) infants and to compare this outcome among 20 centers within a neonatal network.

METHODS: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant morbidities for the first 30 days of life.

RESULTS: Median adjusted estimated LOS from birth was 59 days - 28 days after 30-day point of survival. There was a high correlation between models (r = 0.92). Expected/observed LOS varied widely among centers, even after correction for relevant morbidity after 30 days. Median observed LOS (range: 45-70 days), and postmenstrual age at discharge (range: 36.4-39.9 weeks) reflect high inter-center variability.

CONCLUSION: A simple model, with factors present at birth, can predict a VLBW infant's LOS in a neonatal network. Significant variability in LOS was observed among neonatal intensive care units. We speculate that the results originate in differences in inter-center practices.


23269382 [PubMed - indexed for MEDLINE]
Sociedade Brasileira de Pediatria: Free full text
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