Effect of Increasing the Discharge Bilirubin Level on Readmission Rate in Hyperbilirubinemic Neonates

Jaundice is the most common cause of neonatal readmission. In Amirkola children's hospital, discharge of term neonates with hyperbilirubinemia is done after phototherapy when the total bilirubin level decreases to less than 10 mg/dl. In order to decrease the hospital stay, we increased the discharge bilirubin level from 10 mg/dl to 12 mg/dl and then assessed the effect of this measure on readmission rate. In a cohort study in the neonatal ward at Amirkola children's hospital during the December 2012- June 2013, all term neonates with hyperbilirubinemia with good general condition after phototherapy were discharged when their total serum bilirubin was decreased to less than 10 mg/dl. To decrease the length of hospital stay, in another comparable group the serum bilirubin was increased to12 mg/dl. The readmission rate and also the serum bilirubin level 48 hours after discharge were compared between the two groups. Two hundred and fifty-eight neonates were studied. Serum bilirubin level 48 hours after discharge was 10.46±1.54 mg/dl vs. 11.75±1.78 mg/dl (p< 0.001) and the readmission rate was 2 (1.4%) vs. 9 (8%) (p=0.002) in the group who discharged with bilirubin less than 10 mg/dl and less than 12 mg/dl respectively. Neonates who discharged with a bilirubin less than 12 mg/dl had 6.2 times higher chance of rehospitalization in comparison with neonates discharged with a bilirubin less than 10 mg/dl. Elevating the amount of the discharge bilirubin level from 10 mg/dl to 12 mg/dl in hyperbilirubinemic term neonates, lead to high rate of readmission