Risk factors for hospital readmission among infants with prolonged neonatal intensive care stays

Area of Science:

• Neonatal care
• Pediatric readmission research
• Healthcare quality improvement

Background:

• Prolonged stays in the neonatal intensive care unit (NICU) are associated with increased health complexities for infants.
• Understanding readmission risk factors is crucial for improving post-discharge outcomes and reducing healthcare burdens.

Purpose of the Study:

• To identify key risk factors for 30-day hospital readmission in infants following extended NICU stays.
• To inform targeted interventions for high-risk neonatal populations.

Main Methods:

• Retrospective analysis of 57,035 infants discharged after more than 14 days from the NICU (2013-2016).
• Primary outcome: 30-day, all-cause hospital readmission.
• Multivariable analysis adjusted for demographic, clinical characteristics, and chronic conditions.

Main Results:

• The 30-day readmission rate was 10.7%, with respiratory problems being the most common reason (31.0%).
• Highest readmission likelihood associated with shunted hydrocephalus, gastrostomy tubes, tracheostomies, and public insurance.
• Significant variations in adjusted hospital readmission rates were observed across different hospitals.

Conclusions:

• Infants with indwelling medical devices and public insurance exhibited the highest risk of hospital readmission.
• Findings highlight the need for tailored strategies to mitigate readmission risks in medically and socially complex infants.