{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:12:42Z","timestamp":1788351162904,"version":"build-2803163510"},"reference-count":17,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>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\u2019 Inpatient Database, we constructed an independent 500\u20131499 g cohort from ICD-10-CM birth-weight codes. Mortality, procedure-defined mechanical ventilation, and prolonged hospitalization (\u2265108 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\u20131.432) for mortality, 2.50 (2.14\u20132.93) for mechanical ventilation, and 2.02 (1.75\u20132.33) 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 &lt;3 days; imposing LOS \u2265 3 days increased the mortality aOR to 1.96. Conclusions: NQI03 numerator-code-positive bloodstream infection showed a modest, imprecise association with mortality and more pronounced associations with mechanical ventilation and prolonged hospitalization. Mortality estimates were sensitive to short-stay eligibility. Because infection timing is unavailable, findings are non-causal discharge-level associations.<\/jats:p>","DOI":"10.3390\/children13091182","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:57:23Z","timestamp":1788346643000},"page":"1182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bloodstream Infection and Hospital Outcomes Among Very Low Birth Weight Discharges: Mortality, Mechanical Ventilation, and Prolonged Hospitalization in the 2022 HCUP Kids\u2019 Inpatient Database"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1496-4918","authenticated-orcid":false,"given":"Michael","family":"Samawi","sequence":"first","affiliation":[{"name":"Defense Language Institute Foreign Language Center, 1759 Lewis Road, Monterey, CA 93944, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3817-2249","authenticated-orcid":false,"given":"Hani","family":"Samawi","sequence":"additional","affiliation":[{"name":"Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, Statesboro, GA 30458, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0954-3418","authenticated-orcid":false,"given":"Gulzar H.","family":"Shah","sequence":"additional","affiliation":[{"name":"Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, Statesboro, GA 30458, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Majd","family":"Al-Saleh","sequence":"additional","affiliation":[{"name":"Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, Statesboro, GA 30458, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"11795565241281337","DOI":"10.1177\/11795565241281337","article-title":"Neonatal Sepsis: Aetiology, Pathophysiology, Diagnostic Advances and Management Strategies","volume":"18","author":"Raturi","year":"2024","journal-title":"Clin. Med. Insights Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1016\/S0140-6736(17)31002-4","article-title":"Neonatal Sepsis","volume":"390","author":"Shane","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/s41390-019-0517-2","article-title":"A Neonatal Sequential Organ Failure Assessment Score Predicts Mortality to Late-Onset Sepsis in Preterm Very Low Birth Weight Infants","volume":"88","author":"Wynn","year":"2020","journal-title":"Pediatr. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e2036518","DOI":"10.1001\/jamanetworkopen.2020.36518","article-title":"Evaluation of the Neonatal Sequential Organ Failure Assessment and Mortality Risk in Preterm Infants with Late-Onset Infection","volume":"4","author":"Fleiss","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_5","unstructured":"Agency for Healthcare Research and Quality (2024). 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