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PEDIATRICS Vol. 100 No. 6 December 1997, p. e8

ELECTRONIC ARTICLE:
Rehospitalization With Respiratory Syncytial Virus After Neonatal Intensive Care Unit Discharge: A 3-Year Follow-up

Received May 3, 1997; accepted Jul 16, 1997.

Sharon A. Nachman, Maryam Navaie-Waliser, and Muhammad Z. Qureshi

From the Department of Pediatrics, School of Medicine, State University of New York at Stony Brook, Stony Brook, New York.

Objectives.  This study sought to determine 1) the incidence of rehospitalization with respiratory syncytial virus (RSV) infection within a 3-year follow-up among infants discharged from the neonatal intensive care unit (NICU), and 2) to examine associations between age at readmission and medical and sociodemographic characteristics among infants rehospitalized with RSV.

Methods.  A 3-year retrospective review of NICU discharges at a tertiary care center identified 2506 infants. Using medical record numbers linked with International Classification of Diseases, 9th ed, diagnostic codes for RSV infection, bronchiolitis, or respiratory distress, 67 NICU graduates were identified as having been readmitted from November to April (RSV season). Bivariate analyses and logistic regression modeling were applied to determine the association between a series of predictor variables and age at readmission with RSV by 90 days, 125 days, and 180 days after discharge from the NICU.

Results.  The 3-year incidence of readmission with RSV infection after NICU discharge was 2.7%. During the 3-year follow-up, 6.4% of very low birth weight infants, 2.8% of low birth weight infants, and 1.7% of normal weight infants were readmitted with RSV. Crude results revealed that the presence of bacteremia, intraventricular hemorrhage, and necrotizing enterocolitis, as well as ventilation use, were associated with younger age at readmission with RSV. Simultaneous consideration of the effects of all of these medical predictors and birth weight on age at readmission revealed that normal birth weight was the only significant factor associated with younger age at readmission with RSV.

Conclusions.  This study found significantly lower rates of RSV readmission among NICU graduates than those reported previously in the literature. Based on these data, prophylactic treatment of all preterm infants may not be warranted.

Key words: respiratory syncytial virus, NICU graduates.


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