Clinical Profile and Outcome of Newborns Discharged Against Medical Advice From a Tertiary Care Centre

ABSTRACT

Objective: To determine the clinical profile and outcome of neonates discharged against medical advice (DAMA) from the neonatal intensive care unit (NICU) of a tertiary care public hospital. Methods: We retrieved information from hospital records of infants who had been discharged against medical advice from the NICU between January, 2016 and December, 2020. This was followed by a telephonic interview to document the infant’s outcome. Results: Out of the 187 (7.7%) neonates that had left DAMA, 165 case records were available, and 65 (39%) families could be contacted telephonically. Congenital malformations accounted for 96 (58%) of the cases; cardiac malformations accounting for 42 (43.7%). 52 (80%) out of the 65 infants had died after median (IQR) 11 (5-35) days of DAMA, and 13 (20%) were alive at a median (IQR) age of 31 (18.5-31.5) months. Post-DAMA medical care was continued at another health facility in 12 (18%). Conclusions: One out of every five infants was alive for a median age of 31 months after having left DAMA. Mechanisms to ensure continuation of care after DAMA need to be explored.