Center Variability in Risk of Adjusted Length of Stay for Very Low Birth Weight Infants in the Neocosur South American Network

Objectives: To develop a prediction model for hospital length of stay (LOS) in very low birth weight (VLBW) infants and to compare this outcome among 20 centers within a neonatal network.Methods: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant morbidities for the first 30 days of life.Results: Median adjusted estimated LOS from birth was 59 days 28 days after 30-day point of survival. There was a high correlation between models (r = 0.92). Expected/observed LOS varied widely among centers, even after correction for relevant morbidity after 30 days. Median observed LOS (range: 45-70 days), and postmenstrual age at discharge (range: 36.4-39.9 weeks) reflect high inter-center variability.Conclusion: A simple model, with factors present at birth, can predict a VLBW infant's LOS in a neonatal network. Significant variability in LOS was observed among neonatal intensive care units. We speculate that the results originate in differences in inter-center practices. Pediatr (Rio J). 2012;88(6):524-30