MORTALITY AFTER DISCHARGE FROM NEONATAL INTENSIVE CARE

Abstract

Mortality rates for neonatal intensive care units are often reported as neonatal deaths (<28 days) or deaths prior to discharge from the unit. We investigated deaths occurring after discharge from our intensive care nursery (ICN). Of 1,978 admissions to the Dartmouth-Hitchcock Medical Center ICN for the years 1976-1981, 225 infants died prior to discharge (11.4%). We matched the remaining 1,753 infants with New Hampshire and Vermont death records. We identified 40 post discharge deaths; 33 occurred at age <1 year. Causes of death are recorded below.

Seven of the 8 SIDS infants were premature (out of 1,234 prematures discharged); 6 of the 8 were male; 3 were one of twins. Apnea was identified prior to discharge in only 4 of the SIDS group. Significant pathology in the SIDS group related to the neonatal course included periventricular leukomalacia with cerebellar atrophy, laryngeal fibrosis with stenosis and bronchopulmonary dysplasia.

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