Rehospitalization of extremely-low-birth-weight infants in first 2 years of life.
OBJECTIVE
To determine whether (1) chronic lung disease (CLD) is the prime reason for extremely-low-birth-weight (ELBW) infant readmission during the first 2 years of life, (2) surfactant and other advanced therapies have reduced ELBW infant readmissions, (3) home oxygen therapy (HOT) is efficacious for this group.


METHODS
The hospital records of these ELBW infants were reviewed retrospectively. Data on age, diagnosis, treatment, and duration of each hospitalization were compiled and analyzed for their association to CLD and to readmission for CLD and other reasons.


METHODS
All 60 surviving infants with a birth body weight of less than 1001 g (ELBW) born from January 1993 to February 1998 were followed up to 2 years (mean 20.4 +/- 7.4 months) to evaluate their respiratory outcome.


RESULTS
Forty-two percent of these infants developed CLD. Upon discharge from the hospital, 28% (7/25) of the patients were given HOT for a median period of 60 days. Of the 47 ELBW infants who were studied the entire 2-year period, 72% were readmitted. Infants with CLD were readmitted more frequently (p=0.045) and had longer hospital stays during the first 2 years of life (p=0.034) than those without CLD. Respiratory illness was the main reason for readmission (55%) of these ELBW infants. The incidence of readmission due to respiratory tract infection was not significantly different in infants with CLD (61%) and infants without respiratory complications (44%) (p=0.159).


CONCLUSIONS
Infants with CLD (whether receiving HOT or not) showed no higher readmission rate due to respiratory infection, but the HOT group did have higher morbidity. The premature lung itself rather than the presence of CLD, as we would expect, makes ELBW infants more prone to readmission for respiratory illness.
Chien
Yin Hsiu
YH
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan 23137.
Tsao
Po Nien
PN
Chou
Hung Chieh
HC
Tang
Jen Ruey
JR
Tsou
Kuo Inn
KI
D002908:Chronic Disease; D006701:Home Nursing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008171:Lung Diseases / Q000628:therapy; D010100:Oxygen / Q000627:therapeutic use; D010359:Patient Readmission; D012141:Respiratory Tract Infections / Q000628:therapy
D010100:Oxygen