Hospital Readmissions in Children with Pulmonary Hypertension: A Multi-Institutional Analysis
| Autor: | Jordan D. Awerbach, George B. Mallory, Antonio G. Cabrera, Shelly Kim |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Heart disease Hypertension Pulmonary medicine.medical_treatment Population 030204 cardiovascular system & hematology Patient Readmission law.invention 03 medical and health sciences 0302 clinical medicine Risk Factors law 030225 pediatrics Humans Medicine Child education Retrospective Studies Mechanical ventilation Hospital readmission education.field_of_study business.industry Infant Newborn Infant medicine.disease Readmission rate Intensive care unit Pulmonary hypertension Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Regression Analysis Female Diagnosis code business |
| Zdroj: | The Journal of Pediatrics. 195:95-101.e4 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2017.11.027 |
| Popis: | To assess the rate of and risk factors for 30-day hospital readmission in children with pulmonary hypertension.The Pediatric Health Information System database was analyzed for patients ≤18 years old with pulmonary hypertension (International Classification of Diseases, Ninth Revision, diagnosis codes of 416.0, 416.1, 416.8, or 416.9) admitted from 2005 through 2014. A generalized hierarchical regression model was used to determine significant ORs and 95% CIs associated with 30-day readmission.A total of 13580 patients met inclusion criteria (median age 1.7 years [IQR 0.3-8.7], 45.3% with congenital heart disease). Admissions increased 4-fold throughout the study period. Associated hospital charges increased from $119 million in 2004 to $929 million in 2014. During initial admission, 57.4% of patients required admission to the intensive care unit, and 48.2% required mechanical ventilation. The 30-day readmission rate was 26.3%. Mortality during readmission was 4.2%. Factors increasing odds of readmission included a lower hospital volume of pulmonary hypertension admissions (1.41 [1.23-1.57], P .001) and having public insurance (1.26 [1.16-1.38], P .001). Decreased odds of readmission were associated with older age and the presence of congenital heart disease (0.86 [0.79-0.93], P .001).The pediatric pulmonary hypertension population carries significant morbidity, as reflected by a high use of intensive care unit resources and a high 30-day readmission rate. Younger patients and those with public insurance represent particularly at-risk groups. |
| Databáze: | OpenAIRE |
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