Affiliations: [a] Division of Neonatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| [b] Division of Neonatology, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
| [c] Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| [d] Division of General Academic Pediatrics and Adolescent Medicine, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
Correspondence:
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Address for correspondence: Riddhi K Desai, 5323 Harry Hines Blvd- Suit F3.122, Dallas, TX 75390, USA Tel.: +1 214 648 3903; Email: riddhi.desai@utsouthwestern.edu.
Abstract: BACKGROUND:Current American Academy of Pediatrics guidelines recommend discharge at physiologic maturity regardless of weight; however, our institution’s neonatal ICU policy requires a minimum weight of 1800 g for discharge even when infant is physiologically mature. So, we wanted to determine if discharge at physiologic maturity (PM), based on national guidelines, would decrease hospital days (HD). METHODS:We reviewed 129 infants with birthweight 1300g– 1800 g. Data were analyzed by paired t-test/ Wilcoxon-rank-sum test. RESULTS:Age at discharge vs. age at PM was 0.55d per infant higher (P-value 0.033) resulting in 71 total HD. For SGA babies, this difference was 1.47d vs 0.19d in non-SGA babies (P– value 0.0243) and this difference was an average of 2.63d (P-value < 0.001) for those who reached PM < 1800 g, contributing to 50 of 71 HD potentially saved. CONCLUSION:There was a 0.55–2.6-day difference between age at discharge and age at PM, greater in SGA infants and infants who reached PM prior to 1800 g. There might be an opportunity to send infants home earlier to their families if there is no minimum weight required.
Keywords: Prematurity, small for gestational age (SGA), discharge planning, physiologic maturity (PM), family-centered care, early discharge
