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What factors predict length of stay in a neonatal unit: a systematic review
Sarah E Seaton1, Lisa Barker2, David Jenkins1
1Department of Health Sciences, University of Leicester, Leicester, UK.
Insights
Predicting neonatal length of stay (LOS) is crucial for resource planning. Birth weight, sex, and gestational age are key early predictors, but further research is needed for more accurate estimations.
Area of Science:
- Neonatal Medicine
- Healthcare Management
- Biostatistics
Background:
- 1 in 10 UK babies require specialist neonatal care, with stays ranging from hours to months.
- Increasing survival rates of very preterm infants heighten the demand for neonatal resources.
- Accurate prediction of length of stay (LOS) is essential for effective resource allocation, clinical decision-making, and parental support.
Purpose of the Study:
- To systematically review and identify key factors for predicting length of stay (LOS) in neonatal units.
- To inform resource planning and clinical practice through evidence-based prediction of neonatal care duration.
Main Methods:
- A systematic review was conducted, searching MEDLINE, EMBASE, and Scopus databases.
- Studies published between 1994 and 2016 investigating the prediction of neonatal LOS were included.
- Rigorous inclusion/exclusion criteria were applied, with study quality discussed but not used for exclusion.
Main Results:
- Only 9 studies were identified, highlighting a significant gap in the evidence base for predicting neonatal LOS.
- Inherent factors like birth weight, sex, and gestational age provide a simple, objective method for initial LOS prediction.
- Early-onset factors may also influence LOS, necessitating potential revisions to initial predictions during a baby's hospital stay.
Conclusions:
- Accurate LOS prediction is vital for healthcare service commissioning and parental counseling.
- The current lack of comprehensive evidence underscores the need for larger-scale studies to refine accurate LOS prediction methods.
- Further research should focus on developing and validating models that incorporate various predictive factors for neonatal LOS.
Objective:
In the UK, 1 in 10 babies require specialist neonatal care. This care can last from hours to months depending on the need of the baby. The increasing survival of very preterm babies has increased neonatal care resource use. Evidence from multiple studies is crucial to identify factors which may be important for predicting length of stay (LOS). The ability to predict LOS is vital for resource planning, decision-making and parent counselling. The objective of this review was to identify which factors are important to consider when predicting LOS in the neonatal unit.
Design:
A systematic review was undertaken which searched MEDLINE, EMBASE and Scopus for papers from 1994 to 2016 (May) for research investigating prediction of neonatal LOS. Strict inclusion and exclusion criteria were applied. Quality of each study was discussed, but not used as a reason for exclusion from the review.
Main Outcome Measure:
Prediction of LOS in the neonatal unit.
Results:
9 studies were identified which investigated the prediction of neonatal LOS indicating a lack of evidence in the area. Inherent factors, particularly birth weight, sex and gestational age allow for a simple and objective prediction of LOS, which can be calculated on the first day of life. However, other early occurring factors may well also be important and estimates may need revising throughout the baby's stay in hospital.
Conclusions:
Predicting LOS is vital to aid the commissioning of services and to help clinicians in their counselling of parents. The lack of evidence in this area indicates a need for larger studies to investigate methods of accurately predicting LOS.
