新生儿重症监护室患儿出院31 d内非计划再入院现状及影响因素分析

Current status of unplanned readmission of neonates within 31 days after discharge from the neonatal intensive care unit and risk factors for readmission

摘要:

目的 了解新生儿重症监护室（neonatal intensive care unit，NICU）患儿出院31 d内非计划再入院现状及其影响因素，为制定相关预防策略提供参考。 方法 回顾性收集1 561例NICU出院患儿临床资料，将31 d内发生再次入院的52例患儿作为病例组，采用1∶2病例对照研究的方法，选取同期住院后未发生再入院病例104例作为对照组，对两组患儿的临床资料行单因素分析和多因素logistic回归分析。 结果 1 561例患儿中，52例患儿共发生再入院63次，再入院率为3.33%。高胆红素血症和肺炎是再入院的主要原因，分别占29%（18/63）和24%（15/63）。多因素logistic回归分析结果显示，胎龄<28周、出生体重<1 500 g、多胎妊娠、机械通气、住院时间≤7 d是NICU出院患儿再入院的影响因素（分别OR值为5.645、5.750、3.044、3.331、1.718，P<0.05）。 结论 NICU出院患儿再入院风险较高，医护人员应关注其影响因素，制订针对性干预措施，减少再入院次数，提高医疗服务质量。

Abstract:

Objective To investigate the current status of unplanned readmission of neonates within 31 days after discharge from the neonatal intensive care unit (NICU) and risk factors for readmission. Methods A retrospective analysis was performed on the medical data of 1 561 infants discharged from the NICU, among whom 52 infants who were readmitted within 31 days were enrolled as the case group, and 104 infants who were not readmitted after discharge during the same period of time were enrolled as the control group. Univariate analysis and multivariate logistic regression analysis were performed to identify the risk factors for readmission. Results Among the 1 561 infants, a total of 63 readmissions occurred in 52 infants, with a readmission rate of 3.33%. hyperbilirubinemia and pneumonia were the main causes for readmission, accounting for 29% (18/63) and 24% (15/63) respectively. The multivariate logistic regression analysis showed that that gestational age <28 weeks, birth weight <1 500 g, multiple pregnancy, mechanical ventilation, and length of hospital stay <7 days were risk factors for readmission (OR=5.645, 5.750, 3.044, 3.331, and 1.718 respectively, P<0.05). Conclusions Neonates have a relatively high risk of readmission after discharge from the NICU. The medical staff should pay attention to risk factors for readmission and formulate targeted intervention measures, so as to reduce readmission and improve the quality of medical service.