Short term outcome, complications and average direct cost in managing extremely low birth weight infants in a tertiary care centre in Sri Lanka.

ABSTRACT

Introduction: Data on cost, short term complications and outcome of Sri Lankan extremely low birth weight (ELBW) babies is largely unavailable. Objective: To determine the cost, selected short term complications (surfactant treated and untreated) and short term outcome of ELBW infants in a tertiary care unit in Sri Lanka. Design, setting and method: A descriptive longitudinal study was carried out at Castle Street Hospital for Women over a 6 month period on all ELBW infants, excluding babies who were born after less than 23 completed weeks of gestation and babies who were transferred from the unit. Results: During the study period there were 39 ELBW babies. Ranges of birth weights and maturity were from 540g to 980g (mean 853g) and from 25 weeks to 34+3days respectively. Fifty one percent were small for gestational age. Survival rate was 76.9% at discharge. Hospital stay, intensive care unit stay, duration of mechanical ventilation and supplemental oxygen were 60.6, 13, 3.5 and 9.0 days per survivor respectively. Direct cost per survivor was SLR 82,207. Incidences of complications were 19.4% intraventricular haemorrhage, 8.3% necrotising enterocolitis, 22.2% pulmonary air leak, 11.1% pulmonary haemorrhage and 2.7% patent ductus arteriosus. Average weight gain on discharge was 5.2g/kg/day. Conclusions: Overall survival rate was 77%. IVH was significantly less in surfactant treated babies.