title: Clinical characteristics and outcomes of infants requiring long-term neonatal intensive care.
abstract: This study seeks to better describe the characteristics and outcomes of infants who stay for prolonged periods in the neonatal intensive care unit (NICU). Of 1174 consecutive admissions to a NICU, 73 (6%) met criteria for long-term neonatal intensive care (LTNIC). NICU care totaled 24,631 days; LTNIC infants needed 9152 days (37%). Average NICU stay for LTNIC infants was 125 days (SD +/- 102 days), compared with 14 days +/- 17 days for non-LTNIC infants. The LTNIC infants < or = 1500 gm accounted for 22% of the NICU days of care. There were no differences in gestational age, birth weight, gender, or race between LTNIC and non-LTNIC infants. Survival at discharge was not different, although when neonatal deaths (< or = 28 days) were excluded, the survival of LTNIC infants was significantly less (p < 0.0001). Of 56 LTNIC infants who survived to NICU discharge, 11 (three < or = 1500 gm) subsequently died before 2 years of age, and 10 (six < or = 1500 gm) were probably developmentally delayed. Infants with the longest NICU stays often have multiple medical and surgical problems and unfavorable outcomes, and they consume a disproportionately large percentage of NICU resources. Efforts to contain NICU costs, increase NICU bed availability, and improve NICU outcomes should not ignore infants who require prolonged NICU stays.
authors.affiliation: Department of Pediatrics, Medical College of Georgia, Augusta 30912-3740.
authors.forename: T H
authors.initials: TH
authors.lastname: Davison
authors.forename: W B
authors.initials: WB
authors.lastname: Karp
authors.forename: W P
authors.initials: WP
authors.lastname: Kanto
mesh_terms: D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D044469:Racial Groups; D012737:Sex Factors; D016896:Treatment Outcome