Effect of an Alternate Definition for a Clinically Significant Cardiopulmonary Event on Discharge.
Publication Title
The Journal of pediatrics
Document Type
Article
Publication Date
11-5-2021
Keywords
washington; seattle; swedish
Abstract
OBJECTIVE: To evaluate a precise definition of a clinically significant cardiopulmonary event (CSCPE) on the hospital length of stay (LOS), medical provider satisfaction and discharge complications.
STUDY DESIGN: This is a single-center, observational study that included 139 infants before, and 134 infants after the new definition was implemented in December 2017. Retrospective data collected November 2015 to November 2017 (before) was compared with prospective data from June 2018 to July 2020 (after). Outcome measures were the proportion of infants waiting to outgrow CSCPE, LOS, provider satisfaction with the definition and discharge complications. Multivariate regression modeling was used to evaluate variables on LOS and PMA at discharge.
RESULTS: The proportion waiting to outgrow CSCPE decreased from 68.4% to 31.7% (P < .0001). LOS was similar between groups; however, multivariate analysis correcting for gestational age and reason awaiting discharge estimated 3.5 days (95% CI of 1.4-5.8 days, p=0.0017) decrease in length of stay and 0.92 weeks (CI 0.29-1.56, p=0.005) younger postmenstrual age (PMA) at discharge in the post-CD group. There was no difference in the number of readmissions or emergency room visits for apnea or deaths. Provider satisfaction improved with discharge planning following the implementation of the definition.
CONCLUSIONS: We developed an alternate definition for a CSCPE that decreased the proportion of infants waiting to outgrow a CSCPE but not LOS. There was no difference in the number of readmissions or emergency room visits for apnea or deaths and provider satisfaction in management and discharge planning was greater.
Area of Special Interest
Cardiovascular (Heart)
Area of Special Interest
Women & Children
Specialty/Research Institute
Cardiology
Specialty/Research Institute
Perinatology/Neonatology
Specialty/Research Institute
Pediatrics
