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Neonatal intensive care unit occupancy rate and probability of discharge of very preterm infants

Journal of Perinatology (2023)Cite this article

Subjects

Abstract

Objective

To assess the association of NICU occupancy with probability of discharge and length of stay (LOS) among infants born <33 weeks gestational age (GA).

Study design

Retrospective study of 3388 infants born 23–32 weeks GA, admitted to five Level 3/4 NICUs (2014-2018) and discharged alive. Standardized ratios of observed-to-expected number of discharges were calculated for each quintile of unit occupancy. Multivariable linear regression models were used to assess the association between occupancy and LOS.

Results

At the lowest unit occupancy quintiles (Q1 and Q2), infants were 12% and 11% less likely to be discharged compared to the expected number. At the highest unit occupancy quintile (Q5), infants were 20% more likely to be discharged. Highest occupancy (Q5) was also associated with a 4.7-day (95% CI 1.7, 7.7) reduction in LOS compared Q1.

Conclusion

NICU occupancy was associated with likelihood of discharge and LOS among infants born <33 weeks GA.

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Fig. 1: Standardized ratios for probability of discharge according to NICU occupancy quintiles.
Fig. 2: Standardized ratios for probability of discharge by NICU occupancy quintile stratified according to discharge destination.

Data availability

Data for this study cannot be shared publicly as it is bound by confidentiality agreements governed by hospital and government privacy offices. Aggregate data may be made available from the corresponding author [MB] on reasonable request.

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Acknowledgements

The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network. We also thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of the Canadian Neonatal Network.

Funding

MB holds an Early Career Investigator Grant from the CIHR Institute of Human Development, Child and Youth Health (IHDCYH), a Research Grant Funding from the FRSQ Clinical Research Scholar Career Award Junior 1, and an Early Career Investigator Grant from the Montreal Children’s Hospital Foundation.

Author information

Authors and Affiliations

  1. Division of Neonatology, Montreal Children’s Hospital – McGill University Health Centre, Montreal, QC, Canada

    Marc Beltempo, Sharina Patel & Martine Claveau

  2. McGill University, Montreal, QC, Canada

    Elyonora Sargi, Sharina Patel & Sharon Taylor-Ducharme

  3. Université Laval, Quebec, QC, Canada

    Guy Lacroix, Bruno Piedboeuf & Christine Drolet

  4. Division of Neonatology, Hôpital Sainte-Justine, Montreal, QC, Canada

    Anie Lapointe

  5. Division of Neonatology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada

    Stéphane Morin, Valerie Bertelle & Edith Masse

  6. Division of Neonatology, Jewish General Hospital, Montreal, QC, Canada

    Victoria Bizgu

Authors
  1. Marc Beltempo
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  2. Elyonora Sargi
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  3. Sharina Patel
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  4. Guy Lacroix
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  5. Anie Lapointe
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  6. Sharon Taylor-Ducharme
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  7. Stéphane Morin
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  8. Victoria Bizgu
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  9. Bruno Piedboeuf
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Consortia

Quebec investigators of the Canadian Neonatal Network

  • Marc Beltempo
  • , Martine Claveau
  • , Christine Drolet
  • , Bruno Piedboeuf
  • , Anie Lapointe
  • , Valerie Bertelle
  • , Edith Masse
  •  & Victoria Bizgu

Contributions

MB conceptualized and designed the study, drafted the manuscript, and adjusted the manuscript according to the comments of co-authors. SP collected and analyzed the data, contributed to study design and critically reviewed the manuscript. AL, SM, VB and BP provided administrative support for data access. ES, GL, AL, STD, SM, VB and BP provided review and critical appraisal of the manuscript.

Corresponding author

Correspondence to Marc Beltempo.

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The authors declare no competing interests.

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Beltempo, M., Sargi, E., Patel, S. et al. Neonatal intensive care unit occupancy rate and probability of discharge of very preterm infants. J Perinatol (2023). https://doi.org/10.1038/s41372-022-01596-y

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