title: A population study of respiratory rehospitalisation in very preterm infants in the first 3 years of life.
abstract: OBJECTIVE
  Very premature infants consume healthcare resources following discharge from neonatal intensive care units (NICU). This study aimed to evaluate the burden of respiratory related rehospitalisation within the first 3 years post discharge in very premature infants in an Australian population.
  
  
  METHODS
  Rehospitalisation of a 4-year cohort of NICU survivors, born less than 32 weeks gestation, was derived from data linkage of three state-wide databases including NSW Neonatal Intensive Care Units' Data Collection, Admitted Patient Data Collection and the Death Registry. Rehospitalisation diagnoses were determined by ICD-10 AM codes.
  
  
  RESULTS
  Of the 2939 survivors, 525 (18%) had bronchopulmonary dysplasia (BPD) and 261 BPD infants (50%) were discharged on home oxygen. Almost two-third (1860, 63%) of the survivors are required rehospitalisation, respiratory causes, including 394 respiratory syncytial virus (RSV)-related, accounted for 2668 (48%) of the 5599 rehospitalisations. Significantly more home oxygen BPD survivors had respiratory (70%) and RSV-related (22%) rehospitalisations than the BPD infants not needing home oxygen (58% and 18%, respectively), and the survivors without BPD had the lowest rates (32% and 10%, P < 0.001). Most respiratory (61%) and RSV-related (74%) rehospitalisations occurred during the first 12 months post discharge. No RSV-related fatality occurred. Amongst the total 17 562 hospital days, respiratory and RSV-related admissions accounted for 10 905 (62%) and 3031 (17.2%) days. In multivariable logistic analyses, home oxygen and maternal indigenous status were independently associated with high (3 or more) respiratory and RSV rehospitalisation rates.
  
  
  CONCLUSIONS
  Respiratory rehospitalisations are common in very premature survivors. Home oxygen and indigenous status are significant risk factors for respiratory and RSV-related rehospitalisations.
authors.affiliation: Division of Newborn Services, Royal Hospital for Women, Sydney, Australia.|The Gold Coast Hospital, Gold Coast, Queensland, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Hong
authors.affiliation: Division of Newborn Services, Royal Hospital for Women, Sydney, Australia.|School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Bolisetty
authors.affiliation: NSW Pregnancy and newborn Services Network (PSN), Sydney, New South Wales, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bajuk
authors.affiliation: Department of Neonatology, Centenary Hospital, Canberra, Australian Capital Territory, Australia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Latif
authors.affiliation: Division of Newborn Services, Royal Hospital for Women, Sydney, Australia.
authors.forename: Julee
authors.initials: J
authors.lastname: Oei
authors.affiliation: Division of Newborn Services, Royal Hospital for Women, Sydney, Australia.|School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: Jaffe
authors.affiliation: Division of Newborn Services, Royal Hospital for Women, Sydney, Australia.|School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data; D018357:Respiratory Syncytial Virus Infections
keywords: bronchopulmonary dysplasia; database linkage; population study; premature infants; rehospitalisation; respiratory syncytial virus