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. 2022 Jun 1;149(6):e2021054866.
doi: 10.1542/peds.2021-054866.

Transfer Patterns of Very Low Birth Weight Infants for Convalescent Care

Nansi S Boghossian  1 , Lucy T Greenberg  2   3 , Erika M Edwards  2   4   3 , Jeffrey D Horbar  2   4
Affiliations

Transfer Patterns of Very Low Birth Weight Infants for Convalescent Care

Nansi S Boghossian et al. Pediatrics. .

Abstract

Objectives: To examine the prevalence, characteristics, clinical course, and length of stay (LOS) among 4 groups of infants who were transferred for convalescence and subsequently discharged from the hospital; failed transfer for convalescence and were (a) either readmitted, or (b) transferred again; and were not transferred for convalescence.

Methods: Among very low birth weight infants hospitalized at US Vermont Oxford Network centers between 2006 and 2020, we examined the distribution of characteristics, delivery room and NICU usage measures, outcomes, and LOS among the 4 groups of infants.

Results: Among 641 712 infants, a total of 28 985 (4.5%) infants were transferred for convalescent care; of 28 186 infants, 182 (0.65%) died before hospital discharge and 2551 (9.1%) failed the transfer (1771 [6.3%] were readmitted and 780 [2.8%] were transferred again). There were major regional and NICU variations in the practice of the transfer for convalescence; New England (18.8%) had the highest whereas East South Central (2.2%) had the lowest percentage of transfer for convalescence. Infants who transferred for convalescence and were discharged from the hospital had a similar LOS and similar distribution of NICU usage measures and outcomes to infants who were not transferred for convalescence. Infants who failed the transfer for convalescence had a longer LOS than infants who were transferred for convalescence and then discharged from the hospital.

Conclusions: The rates of transfer for convalescence and transfer for convalescence failure were low. Future studies should weigh the risks and benefits of transfer for convalescence, which might differ on the basis of geography.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLAIMER: Ms Greenberg reported receiving compensation from Vermont Oxford Network for serving as a statistician. Dr Horbar is an employee of Vermont Oxford Network and Dr Edwards receives salary support from Vermont Oxford Network. The other authors have indicated they have no conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Disposition status of inborn and outborn infants. aInfants born in 2015 or later. VON did not identify the birth hospitals of outborn infants before 2015. bData missing for 1536 infants. cData missing for 5 infants. dData missing for 173 infants. eExcludes 280 infants born before 29 weeks gestational age and transferred within 4 days of birth. fData missing for 799 infants. gData missing for 41 infants. hData missing for 2 infants. iData missing for 8 infants.
FIGURE 2
FIGURE 2
Risk factors for failed transfer for convalescence based on modified Poisson multiple regression model.
FIGURE 3
FIGURE 3
LOS (days) by disposition status. LOS data missing for 1,155 infants. The line represents the median (50th percentile). The borders of the box plot represent the 25th and 75th percentiles. The whiskers represent the minimum and maximum LOS. IQR, interquartile range.
See this image and copyright information in PMC

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