Admission patterns and outcomes in the Neonatal Intensive Care Unit (NICU) at King Faisal Hospital, Kigali: a retrospective study

Abstract

Background Less is known about the determinants of poor clinical outcomes of neonatal admissions in Rwandan tertiary hospitals. This study aims to determine neonatal admission patterns and the factors associated with poor clinical outcomes in the NICU at King Faisal Hospital Methods This was a retrospective study of neonatal patients admitted to the NICU between January 1, 2019 and December 31, 2020. The sample consisted of all records of newborns admitted with documented admission outcomes. The dependent variable was a neonatal admission’s results, defined as alive or dead at discharge. Independent variable was general information related to admission, neonatal factors, and parental factors. For data analysis, SPSS version 21 was used, and frequencies and percentages were used to present descriptive data. Logistic regression model was performed for bivariate and multivariable analysis and a P value < 0.05 indicated a level of significance and the odd ratios (OR) and 95% CI were used to present these associations. Results Of 284 recorded newborn admissions during study period, about 70% had RDS and 58.5% were males and almost 52% were admitted ≥ 1 hour from birth. About, 88% of admitted newborn were discharged alive versus nearly 12% who were discharged dead. RDS was reported to be the most cause of death with 41.2% follows by neonatal infection with 26.5%. The poor discharge outcome was found to be associated with neonatal factors such as congenital anomaly and low neonatal admission weight. The number of preterm pregnancies, ranging from 2-4 to none was found as maternal factors associated with poor admission outcome of newborn admitted at KFH, K, NICU. Conclusion Our results revealed that RDS was the most frequent cause of neonatal admissions. Neonatal factors associated with this poor outcome were congenital anomaly and low neonatal weight on admission whereas the number of preterm pregnancies was the maternal factor associated with poor admission outcome of neonatal admissions. Timely respiratory support for all emergency cesarean sections and for babies born a less than 37.6 weeks' gestational age and availability of neonatologist all the time are needed.