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Neonatal intensive care unit: predictive models for length of stay.
Bender, G J; Koestler, D; Ombao, H; McCourt, M; Alskinis, B; Rubin, L P; Padbury, J F.
Afiliación
  • Bender GJ; Department of Pediatrics, Women & Infants' Hospital of Rhode Island, Providence, RI 02905-2499, USA. gbender@wihri.org
J Perinatol ; 33(2): 147-53, 2013 Feb.
Article en En | MEDLINE | ID: mdl-22678140
OBJECTIVE: Hospital length of stay (LOS) is important to administrators and families of neonates admitted to the neonatal intensive care unit (NICU). A prediction model for NICU LOS was developed using predictors birth weight, gestational age and two severity of illness tools, the score for neonatal acute physiology, perinatal extension (SNAPPE) and the morbidity assessment index for newborns (MAIN). STUDY DESIGN: Consecutive admissions (n=293) to a New England regional level III NICU were retrospectively collected. Multiple predictive models were compared for complexity and goodness-of-fit, coefficient of determination (R (2)) and predictive error. The optimal model was validated prospectively with consecutive admissions (n=615). Observed and expected LOS was compared. RESULT: The MAIN models had best Akaike's information criterion, highest R (2) (0.786) and lowest predictive error. The best SNAPPE model underestimated LOS, with substantial variability, yet was fairly well calibrated by birthweight category. LOS was longer in the prospective cohort than the retrospective cohort, without differences in birth weight, gestational age, MAIN or SNAPPE. CONCLUSION: LOS prediction is improved by accounting for severity of illness in the first week of life, beyond factors known at birth. Prospective validation of both MAIN and SNAPPE models is warranted.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Unidades de Cuidado Intensivo Neonatal / Modelos Estadísticos / Enfermedades del Recién Nacido / Tiempo de Internación Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Perinatol Asunto de la revista: PERINATOLOGIA Año: 2013 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Unidades de Cuidado Intensivo Neonatal / Modelos Estadísticos / Enfermedades del Recién Nacido / Tiempo de Internación Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Perinatol Asunto de la revista: PERINATOLOGIA Año: 2013 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos