Infections and risk-adjusted length of stay and hospital mortality in Polish Neonatology Intensive Care Units.
BACKGROUND
The objectives of this study were to analyze the impact of infections on prolonging hospital stay with consideration of underlying risk factors and determining the mortality rates and its association with infections.


METHODS
An electronic database developed from a continuous prospective targeted infection surveillance program was used in the study. Data were collected from 2009 to 2012 in five Polish tertiary academic neonatal intensive care units (NICUs). The length of stay (LOS) of 2,003 very low birth weight (VLBW) neonates was calculated as the sum of the number of days since birth until death or until reaching a weight of 1,800g.


RESULTS
The median LOS for neonates with infections was twice as high as for neonates without infection. LOS was significantly affected by the overall general condition of the neonate, as expressed by both gestational age and birth weight as well as by the Clinical Risk Index for Babies (CRIB) score; another independent factor was presence of at least one infection. Risk of in-hospital mortality was significantly increased by male sex and vaginal birth and was lower among breastfed neonates. Deaths were significantly more frequent in neonates without infection.


CONCLUSIONS
The general condition of VLBW infants statistically increase both their risk of mortality and LOS; this is in contrast to the presence of infection, which significantly prolonged LOS only.
Chair of Microbiology, Jagiellonian University Medical College, Krakow, Poland. Electronic address: rozanska@ifb.pl.
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Różańska
Chair of Microbiology, Jagiellonian University Medical College, Krakow, Poland.
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Wójkowska-Mach
Institute of Nature Conservation, Polish Academy of Sciences, Krakow, Poland.
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P
Adamski
Clinic of Neonatology and Intensive Neonatal Care, Warsaw Medical University, Warsaw, Poland.
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Borszewska-Kornacka
Clinic of Neonatology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland.
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Gulczyńska
Clinic of Neonatology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland.
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Nowiczewski
Clinic of Neonatology and Intensive Neonatal Care, Institute of Mother and Child, Warsaw, Poland.
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E
Helwich
Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Poland.
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Kordek
Clinic of Neonatology, Jagiellonian University Medical College, Krakow, Poland.
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Pawlik
Chair of Microbiology, Jagiellonian University Medical College, Krakow, Poland.
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M
Bulanda
D001724:Birth Weight; D003428:Cross Infection / Q000401:mortality*; D005260:Female; D005865:Gestational Age; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D011044:Poland; D012307:Risk Factors
in-hospital mortality; length of stay; neonatal infections; very low birth weight