Health service utilisation for acute respiratory infections in infants graduating from the neonatal intensive care unit: a population-based cohort study

• Published in: BMC pediatrics 2023-07, Vol.23 (1), p.335-335, Article 335
• Main Authors: Stevenson, Paul G, Cooper, Matthew N, Billingham, Wesley, de Klerk, Nicholas, Simpson, Shannon J, Strunk, Tobias, Moore, Hannah C
• Format: Article
• Language: English
• Subjects: Acute respiratory infection; Age groups; Care and treatment; Child; Children & youth; Classification; Codes; Cohort analysis; Data collection; Datasets; Diagnosis; Disease prevention; Dosage and administration; Emergency medical care; Gestational age; Health services utilization; Hospital morbidity; Hospitalization; Hospitals; Infant; Infants (Newborn); Infections; Influenza; Intensive care; Medical care; Morbidity; Mortality; Neonatal care; Neonatal intensive care; Neonatal intensive care unit; Newborn babies; Palivizumab; Patient admissions; Pediatrics; Population-based studies; Premature birth; Record linkage; Respiratory distress syndrome; Respiratory syncytial virus; Services; Utilization
• ISSN: 1471-2431; 1471-2431
• DOI: 10.1186/s12887-023-04152-5

Despite advances in neonatal intensive care, babies admitted to Neonatal Intensive Care Units (NICU) suffer from adverse outcomes. We aim to describe the longer-term respiratory infectious morbidity of infants discharged from NICU using state-wide population-based linked data in Western Australia. We used probabilistically linked population-based administrative data to analyse respiratory infection morbidity in a cohort of 23,784 infants admitted to the sole tertiary NICU, born 2002-2013 with follow up to 2015. We analysed incidence rates of secondary care episodes (emergency department presentations and hospitalisations) by acute respiratory infection (ARI) diagnosis, age, gestational age and presence of chronic lung disease (CLD). Poisson regression was used to investigate the differences in rates of ARI hospital admission between gestational age groups and those with CLD, after adjusting for age at hospital admission. From 177,367 child-years at risk (i.e., time that a child could experience an ARI outcome), the overall ARI hospitalisation rate for infants and children aged 0-8 years was 71.4/1000 (95% confidence interval, CI: 70.1, 72.6), with the highest rates in infants aged 0-5 months (242.9/1000). For ARI presentations to emergency departments, equivalent rates were 114/1000 (95% CI: 112.4, 115.5) and 337.6/1000, respectively. Bronchiolitis was the most common diagnosis among both types of secondary care, followed by upper respiratory tract infections. Extremely preterm infants (