Home apnea monitor use in preterm infants discharged from newborn intensive care units

Purpose: To identify current factors associated with home apnea monitor use in preterm infants and to determine whether home monitor use was associate d with a shorter length of hospital stay. Setting: We evaluated neonates who were less than or equal to 34 weeks' est imated gestational age and admitted for neonatal intensive care. We exclude d neonates with congenital anomalies, neonates transferred out before disch arge, and neonates who died. Methods: Using a database created with a computer-assisted tool that genera tes hospital notes, we reviewed the epidemiology of monitor use. Difference s between neonates sent home with an apnea monitor and those who were not w ere evaluated by using stepwise logistic regression analysis to identify wh ich factors were independently associated with a neonate being discharged w ith a monitor. Results: We studied 14,532 neonates; 1588 (11%) were sent home with monitor s and 12,944 (89%) were not. The most important variables associated with b eing discharged with a monitor were site of care and a diagnosis of apnea. Site variation remained significant when adjusted for gestational age, diag nosis of apnea, and a history of use of methylxanthines. When corrected for gestational age, monitor use was not associated with shorter hospital stay s. Conclusion: The data suggest that monitor use is more dependent on physicia n preference than medical indication and is not associated with earlier hos pital discharge.