Effect of Phototherapy on Neonatal Hospital Stay Público

White, Lauren A (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/hq37vp37b?locale=es
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Abstract

Neonatal hyperbilirubinemia and neonatal jaundice are two of the most common neonatal outcomes. Hyperbilirubinemia is the accumulation of bilirubin, a product of red blood cell breakdown, manifesting through neonatal jaundice, or a yellowing of the skin and sclera of affected infants. Infants with high serum bilirubin levels, preterm infants, observed jaundice before discharge, and siblings with previous jaundice are at increased risk for hyperbilirubinemia. Hyperbilirubinemia is treated with phototherapy (PT), which involves exposing infants to light, to facilitate bilirubin breakdown and excretion. Healthy term infants are usually discharged from the hospital within 48 hours of birth, but a number of factors can lead to an extended stay. There is limited evidence on how PT treatment affects LOS. Our study utilized data on infants born at two metro Atlanta hospitals over a two-year period to determine if infants receiving PT had increased lengths of stay (LOS). We restricted our analysis to infants with a complete neonatal record, and a hospital stay fewer than 16 days. Fifteen percent (137) of infants received PT. A greater percentage of infants who received PT were small for gestational age, born in hospital 2, and bottle-fed. Infants who did not receive PT had a mean LOS of 2.3±1.8 days, compared to mean LOS of 5.0±3.7 days for infants treated with PT. Four survival analysis models were run to evaluate differences in LOS based on PT treatment. Infants who received PT were 2.6 (95% CI 1.92, 4.20) times more likely to have an extended hospital stay when compared to infants who did not receive PT. When stratified on hospital, which controlled for sociodemographic variables including race and insurance type, hazard ratios did not significantly differ. We concluded that infants who received PT had significantly longer LOS than untreated infants. The results of our stratified analysis suggest that PT does not differentially affect respective hazard ratios on the basis of sociodemographic factors.

Table of Contents

Chapter I: Background/Literature Review.................................................................. 1

Chapter II: Manuscript................................................................................................... 11

Abstract....................................................................................................................... 11

Introduction................................................................................................................ 12

Methods...................................................................................................................... 14

Results......................................................................................................................... 17

Discussion................................................................................................................... 20

References........................................................................................................................ 25 Tables................................................................................................................................ 29 Figures.............................................................................................................................. 33

Chapter III: Implications................................................................................................ 34

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