Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Evaluation of goodness of fit of semiparametric and parametric models in analysis of factors associated with length of stay in neonatal intensive care unit

  • Kheiry, Fatemeh (Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences) ;
  • Kargarian-Marvasti, Sadegh (Department of Epidemiology, Isfahan University of Medical Sciences) ;
  • Afrashteh, Sima (Department of Public Health, Faculty of Health, Bushehr University of Medical Sciences) ;
  • Mohammadbeigi, Abolfazl (Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences) ;
  • Daneshi, Nima (Behbahan Faculty of Medical Sciences) ;
  • Naderi, Salma (Department of Pediatrics, Faculty of Medicine, Clinical Research Development Centre of Children Hospital, Hormozgan University of Medical Sciences) ;
  • Saadat, Seyed Hossein (Faculty of Medicine, Clinical Research Development Center of Children's Hospital, Hormozgan University of Medical Sciences)
  • Received : 2019.05.09
  • Accepted : 2020.01.31
  • Published : 2020.09.15
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Abstract

Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.

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  1. Survival model application for analysis of neonatal length of stay vol.63, pp.9, 2020, https://doi.org/10.3345/cep.2019.01508