Health Policy & Community Health: Faculty Publications

Bloodstream infection and hospital outcomes among very low birth weight discharges: Mortality, mechanical ventilation, and prolonged hospitalization in the 2022 HCUP Kids' Inpatient Database

Document Type

Article

Publication Date

9-2-2026

Publication Title

Children

DOI

10.3390/children13091182

Abstract

Background/Objectives: We examined discharge-level associations between an administrative NQI03 numerator-code-positive bloodstream infection construct and hospital outcomes in very low birth weight (VLBW) discharges and whether the NQI03 short-stay criterion altered mortality estimates. Methods: Using the 2022 HCUP Kids' Inpatient Database, we constructed an independent 500--1499 g cohort from ICD-10-CM birth-weight codes. Mortality, procedure-defined mechanical ventilation, and prolonged hospitalization ($108 days, cohort P90) were modeled with adjustment for birth weight, completed gestational age, patient/discharge characteristics, and hospital characteristics. Missing baseline covariates were addressed with 50 multiple imputations; survey-design, transfer/inborn, short-stay, and model-specification sensitivities were examined. Results: Among 39,630 discharges from 1750 hospitals, 1655 (4.18%) were NQI03 numerator-code-positive. Multiple-imputation aORs were 1.20 (95% CI 1.005--1.432) for mortality, 2.50 (2.14--2.93) for mechanical ventilation, and 2.02 (1.75--2.33) for prolonged hospitalization; corresponding adjusted risk ratios were 1.17, 1.29, and 1.60. Secondary complete-case record-level standardized probabilities were 7.5% versus 6.5%, 58.6% versus 42.6%, and 15.4% versus 9.5%, respectively; uncertainty for these estimates is reported using hospital-cluster bootstrap confidence intervals. Of 3041 deaths, 1528 (50.25%) occurred during stays

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