Rehospitalization of Very Low Birth Weight Infants in the First Year after Discharge from NICU and Risk Factor of Rehospitalization caused by Respiratory Illness

PURPOSE: The rehospitalization rate after discharge from neonatal intensive care unit (NICU) has been used as an indicator of morbidity of very low birth weight infants (VLBWI). We investigated the rate and the causes of rehospitalization of VLBWI who were discharged from our NICU, and analyzed the risk factors of their rehospitalization caused by respiratory illness. METHODS: 276 VLBWI who was discharged from NICU of Samsung Medical Center from January 2001 to December 2003, and followed up at least for 1 year were enrolled. Our study was based on the retrospective review of the medical records. RESULTS: The rehospitalization rate of VLBWI was 28%. The number of VLBWI rehospitalized was 106 in total. Causes of rehospitalization were respiratory illness (56%), genitourinary problem (20%), infectious problem (9%), and gastro-intestinal problem (7%) in order of frequency. 79% of rehospitalization had occurred within six months after discharge from NICU. In respiratory group, four patients required mechanical ventilation, one patient had expired, and the rate of respiratory syncytial virus (RSV) infection was 32%. The respiratory group had been younger in the gestational age, longer in the duration of hospitalizaton and the ventilator care period. And the respiratory group had been higher in the ratio of bronchopulmonary dysplasia than the control group. CONCLUSION: For reduced rehospitalization caused by respiratory illness of VLBWI, we suggest some programs that will decrease the incidence of bronchopulmonary dysplasia. This program will enable inpatients to make early discharge from NICU, whereas efforts for effective aftercare following the discharge from NICU are required.

A Case of Axenfeld-Rieger Syndrome with Severe Mitral Regurgitation

Axenfeld-Rieger syndrome is a rare autosomal dominant inherited developmental disorder characterized by ocular and systemic abnormalities. In ocular anomaly, it includes a prominent and anteriorly displaced Schwalbe line and an iridocorneal synechiae, iris hypoplasia, corectopia and secondary glaucoma. Extraocular developmental abnormalities of the syndrome are hearing loss, congenital heart disease, dental anomalies, developmental delay, and a characteristic facial appearance. We herein reported a familial case of Axenfeld-Rieger syndrome that had a mitral valve prolapse with severe mitral regurgitation finally requiring mitral valve replacement.