Pre-discharge Cardiorespiratory Monitoring in Preterm Infants. the CORE Study

Objective:Ensuring cardiorespiratory (CR) stability is essential for a safe discharge. The aim of this study was to assess the impact of a new pre-discharge protocol named CORE on the risk of hospital readmission (RHR). Methods:Preterm infants admitted in our NICU between 2015 and 2018 were randomly assigned to CORE (exposed) or to standard (not-exposed) discharge protocol. CORE included 24 h-clinical observation, followed by 24 h-instrumental CR monitoring only for high-risk infants. RHR 12 months after discharge and length of stay represent the primary and secondary outcomes, respectively. Results:Three hundred and twenty three preterm infants were enrolled. Exposed infants had a lower RHR (log-rankp< 0.05). The difference was especially marked 3 months after discharge (9.09 vs. 21.6%;p= 0.004). The hospital length of stay in exposed and not-exposed infants was 39(26-58) and 43(26-68) days, respectively (p= 0.16). Conclusions:The CORE protocol could help neonatologists to define the best timing for discharge reducing RHR without lengthening hospital stay.