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Prolonged neonatal jaundice in RegionÖrebro County : - a comparison of two management strategiesPerpåls, Adina January 2022 (has links)
Introduction: Prolonged neonatal jaundice is defined as persistent jaundice at two-three weeksof age. Prolonged neonatal jaundice is usually harmless but one in 2500 newborns have jaundicedue to cholestasis, why further investigation must be made. Region Örebro County introduced anew referral routine for prolonged neonatal jaundice 2021-02-12 that allows for follow up inLindesberg or Karlskoga instead of Örebro alone, and only three variables need to be mentionedfor the referrals to be considered complete, contrary to previous six. Aim: To compare Region Örebro County’s current and previous referral routine for prolongedneonatal jaundice in regard to compliance and complete referrals. Methods: A chart review was performed of all children born in Region Örebro County between2021-02-12 and 2022-02-01 with either sampled bilirubin and/or diagnosis code p.55, p.57-59. Results: A statistically significant difference was observed between the routines regarding stoolcolour (p=0.004), general condition (p<0.001), complete referrals (p<0.001) and length ofinvestigation (p<0.001). Significantly fewer patients were lost during investigation (p<0.002) orhad no feedback on their test results (p<0.011). Two cases of cholestasis were found. The meanvalue of conjugated bilirubin was higher in patients who saw a doctor. Few children werereferred from Lindesberg or Karlskoga. Conclusion: The current routine had more complete referrals, shorter investigation times andless absence of feedback as well as fewer patients lost during investigation. Sick patients wereidentified before getting critically ill. Shifting the entire investigation to primary care andimplementing stool charts could possibly improve the routine further.
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