Factors Associated with Readmission of Patients with Congenital Heart Disease in a Swiss University Hospital

Abstract

Background: Congenital heart defects (CHD) lead to extensive use of healthcare resources. Still, there is little information available regarding readmission rates or associated factors. We sought to evaluate readmission rates and their determinants among patients with CHD hospitalized in a Swiss university hospital. Methods: Retrospective study using data from all non-adult (<18 years) patients hospitalised between 2002 and 2014 at the University Hospital of Lausanne with an International Classification of Diseases (ICD) version 10 code Q20 to Q25. Results: 996 patients (460 girls, 332 undergoing surgery, mean age 2.7 years) were assessed, 96 of whom (9.6%) were readmitted within 30 days after discharge. Among the 96 readmissions, 83 (86.5%) were related to the CHD. Median time to readmission was 10 days (interquartile range: 6-20) and median length of readmission was 12 days (interquartile range: 6-20). After multivariate adjustment, foreign nationality, greater distance to hospital and length of index hospitalisation <14 days predisposed to readmission. Patients who underwent surgery were less likely to be readmitted (8.7%). Conclusion: Readmissions were frequent, almost 1 in 10 patients, and associated with several socioclinical factors. Providing patients who live far from hospital with specialized care closer to home may help reduce the rate of readmission.

Readmission After Pediatric Cardiothoracic Surgery: An Analysis of The Society of Thoracic Surgeons Database

“…As a result, rates of readmission were quite variable and dependent on the specific center's characteristics, the patient cohort diagnosis and operation, and the age group of the patients. For example, readmission rates across single-center studies have varied from 8.7% to 11.3% and are consistent with the range of readmission rates that we report (median, 10.1%; IQR 8.2% to 12.9%) [9][10][11].…”

Biomarkers improve prediction of 30-day unplanned readmission or mortality after paediatric congenital heart surgery

“…There are increasing efforts to identify children at increased risk of readmission following congenital heart surgery. [41][42][43][44][45][46][47][48] Kogon and colleagues identified ethnicity, pre-operative failure to thrive, and post-operative length of stay as significant predictors of readmission. 2 Others reported arrhythmia, post-pericardiotomy syndrome, and infectious complications were the most common readmission diagnoses, 46 or they found infectious complications to be a common readmission diagnosis in children who had previously undergone Norwood palliation for hypoplastic left heart syndrome.…”

Novel Biomarkers Improve Prediction of 365-Day Readmission After Pediatric Congenital Heart Surgery

“…There is an increasing focus to identify children at greater risk of readmission after congenital heart surgery. 3,[25][26][27][28] An improved understanding of a child's estimated risk of readmission or mortality can be valuable when determining the appropriate timing of surgery, surgical alternatives, or customized hospital discharge instructions. Kogon and colleagues 4 identified preoperative failure to thrive, postoperative length of stay, and ethnicity as significant predictors of readmission.…”