Archives of disease in childhood. Fetal and neonatal edition · 2022
Comparison of neonatal morbidity and mortality between single-room and open-bay care: a retrospective cohort study.
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Jansen Sophie, Berkhout Romy J M, Te Pas Arjan B, Steggerda Sylke J, de Vries Linda S, Schalij-Delfos Nicoline, van der Hoeven Alieke, Lopriore Enrico, Bekker Vincent
Аннотация
OBJECTIVE: In response to the increasing focus on family-centred care, neonatal intensive care unit (NICU) environments have gradually shifted towards the single-room design. However, the assumed benefits of this emerging design remain a subject of debate. Our goal was to evaluate the impact of single-room versus open-bay care on the risk of neonatal morbidity and mortality in preterm neonates.
DESIGN: Retrospective cohort study.
SETTING: Level III NICU.
PATIENTS: Neonates born <32 weeks' gestation between 15 May 2015 and 15 May 2019.
MAIN OUTCOME MEASURES: Mortality and morbidities of a cohort of neonates admitted to a new, single-room unit (SRU) were compared with a historical cohort of neonates admitted to an open-bay unit (OBU). Group differences were evaluated and multivariable logistic regression analyses were performed.
RESULTS: Three-hundred and fifty-six and 343 neonates were admitted to the SRU and OBU, respectively. No difference in neonatal morbidities and mortality were observed between cohorts (bronchopulmonary dysplasia: OR 1.08, 95% CI 0.73 to 1.58, p=0.44; retinopathy of the prematurity stage ≥2: OR 1.36, 95% CI 0.84 to 2.22, p=0.10; intraventricular haemorrhage: OR 0.89, 95% CI 0.59 to 1.34, p=0.86; mortality: OR 1.55, 95% CI 0.75 to 3.20, p=0.28). In adjusted regression models, single-room care was independently associated with a decreased risk of symptomatic patent ductus arteriosus (adjusted OR 0.54, 95% CI 0.31 to 0.95). No independent association between single-room care and any of the other investigated outcomes was observed.
CONCLUSIONS: Implementation of single-rooms in our NICU did not lead to a significant reduction in neonatal morbidity and mortality outcomes.
DESIGN: Retrospective cohort study.
SETTING: Level III NICU.
PATIENTS: Neonates born <32 weeks' gestation between 15 May 2015 and 15 May 2019.
MAIN OUTCOME MEASURES: Mortality and morbidities of a cohort of neonates admitted to a new, single-room unit (SRU) were compared with a historical cohort of neonates admitted to an open-bay unit (OBU). Group differences were evaluated and multivariable logistic regression analyses were performed.
RESULTS: Three-hundred and fifty-six and 343 neonates were admitted to the SRU and OBU, respectively. No difference in neonatal morbidities and mortality were observed between cohorts (bronchopulmonary dysplasia: OR 1.08, 95% CI 0.73 to 1.58, p=0.44; retinopathy of the prematurity stage ≥2: OR 1.36, 95% CI 0.84 to 2.22, p=0.10; intraventricular haemorrhage: OR 0.89, 95% CI 0.59 to 1.34, p=0.86; mortality: OR 1.55, 95% CI 0.75 to 3.20, p=0.28). In adjusted regression models, single-room care was independently associated with a decreased risk of symptomatic patent ductus arteriosus (adjusted OR 0.54, 95% CI 0.31 to 0.95). No independent association between single-room care and any of the other investigated outcomes was observed.
CONCLUSIONS: Implementation of single-rooms in our NICU did not lead to a significant reduction in neonatal morbidity and mortality outcomes.