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Incidence of bronchopulmonary dysplasia down since 1990s
Stroustrup A. Pediatrics. 2010;doi:10.1542/peds.2009-3456.
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Although the incidence of bronchopulmonary dysplasia diagnoses has decreased among premature neonates during the past 14 years, hospitalization costs and length of stay increased for patients with this condition, according to a study.
Researchers obtained records for 47,465,901 neonatal hospitalizations from 1993 to 2006 from the Nationwide Inpatient Sample to determine the trends in bronchopulmonary dysplasia (BPD) diagnosis and health services used as a result of BPD. They analyzed the function of changes in diagnosis of very low birth weight (VLBW) neonates and various methods of respiratory support used for treatment.
Between 1993 and 2006, BPD diagnosis fell 3.3% annually (P=.0009). During this time, there was a 3.5-fold increase in the use of noninvasive respiratory support among patients with BPD. After adjusting for demographics, the researchers reported a persistent decrease in BPD diagnosis of 4.3% annually (P=.0002).
Four models were used to evaluate trends: incidence of BPD and trends in hospital length of stay and costs; incidence of BPD and trends in hospital length of stay and costs controlled for VLBW; incidence of BPD and trends in hospital length of stay and costs controlled for VLBW and continuous positive airway pressure; and incidence of BPD and trends in hospital length of stay and costs controlled for VLBW and ventilation. Among all models, an annual rise persisted for length of stay (ranging from 1.8% to 3.9%) and hospitalization costs (ranging from 2.7% to 4.9%).
According to the researchers, the incidence of BPD adjusted for occurrence of prolonged mechanical ventilation decreased by 2.8% annually (P=.0075).
“On the basis of our results for data analyses controlled for the increase in VLBW births, we conclude that the incidence of BPD has decreased since the early 1990s after multiple changes in management strategies aimed at improving long-term pulmonary outcomes,” the researchers wrote. “Global improvements in neonatal care have clearly had an impact of functional pulmonary outcomes in neonates.”