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Estimating neonatal length of stay for babies born very preterm
  1. Sarah E Seaton1,
  2. Lisa Barker2,
  3. Elizabeth S Draper1,
  4. Keith R Abrams1,
  5. Neena Modi3,
  6. Bradley N Manktelow1
  7. on behalf of the UK Neonatal Collaborative
    1. 1 Department of Health Sciences, University of Leicester, Leicester, UK
    2. 2 Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
    3. 3 Neonatal Data Analysis Unit, Section of Neonatal Medicine, Department of Medicine, Imperial College London, London, UK
    1. Correspondence to Dr Sarah E Seaton, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK; sarah.seaton{at}leicester.ac.uk

    Abstract

    Objective To predict length of stay in neonatal care for all admissions of very preterm singleton babies.

    Setting All neonatal units in England.

    Patients Singleton babies born at 24–31 weeks gestational age from 2011 to 2014. Data were extracted from the National Neonatal Research Database.

    Methods Competing risks methods were used to investigate the competing outcomes of death in neonatal care or discharge from the neonatal unit. The occurrence of one event prevents the other from occurring. This approach can be used to estimate the percentage of babies alive, or who have been discharged, over time.

    Results A total of 20 571 very preterm babies were included. In the competing risks model, gestational age was adjusted for as a time-varying covariate, allowing the difference between weeks of gestational age to vary over time. The predicted percentage of death or discharge from the neonatal unit were estimated and presented graphically by week of gestational age. From these percentages, estimates of length of stay are provided as the number of days following birth and corrected gestational age at discharge.

    Conclusions These results can be used in the counselling of parents about length of stay and the risk of mortality.

    • neonatal
    • neonatal intensive care
    • length of stay

    This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: https://creativecommons.org/licenses/by/4.0/

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    Footnotes

    • Contributors SES conceived the idea and undertook the analysis, under the supervision of BNM, ESD and KRA. SES wrote the first draft of the paper. NM and LB provided clinical context and medical insight. All authors contributed towards the manuscript, revising it critically for intellectual content. All authors have read and approved this final version of the manuscript.

    • Funding This paper presents independent research funded by the National Institute for Health Research (NIHR).

    • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests SS is funded by a National Institute for Health Research Doctoral Research Fellowship award (DRF-2013-06-011). KA is partially supported by the National Institute for Health Research (NIHR) as a senior investigator (NF-SI-0512-10159).

    • Ethics approval Research ethics approval was granted for this study from Lancaster, North West Research Ethics Committee (REC reference: 14/NW/0349).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Information on how to obtain data from the NNRD can be found at: http://www.imperial.ac.uk/neonatal-data-analysis-unit/neonatal-data/utilising-the-nnrd/.

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