Frequency and cause of readmissions following pediatric otolaryngologic surgery

Murray, Ryan R.; Logvinenko, Tanya; Roberson, David W.

doi:10.1002/lary.25250

Cited by 11 publications

(14 citation statements)

References 15 publications

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“…In general, patients with longer LOS at index admission were found in seven studies to be at greater risk of readmission following surgical procedures (OR=1.01 to 13.96)72 79 81 82 86 90 although one study87 found shorter than 3 days of hospitalisation at the index admission was a risk factor for patients who underwent spinal fusion (OR=1.89).…”

Section: Resultsmentioning

confidence: 99%

“…Age at index admission or surgery72 77 78 82 85 90 and the ASA class71 75 80 83 84 89 were cited in six differing studies. Age, however, was inconsistent across the studies.…”

Section: Resultsmentioning

confidence: 99%

“…Age, however, was inconsistent across the studies. For example, patients either younger than 1 year78 with urological surgeries or older than 13 years72 with ENT surgeries were more likely to be readmitted. The ASA class of 3 and above was associated with higher risk of UHRs (OR=1.78 to 7.62).…”

Section: Resultsmentioning

confidence: 99%

“…Public insurance,72 73 87 longer operating time,75 76 86 and severe health conditions prior to surgeries72 79 86 were all cited three times in different studies as increasing the risk of patients UHRs. Other significant risk factors related to surgical procedure related UHRs are displayed in table 2.…”

Section: Resultsmentioning

confidence: 99%

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Risk factors associated with paediatric unplanned hospital readmissions: a systematic review

et al. 2019

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ObjectiveTo synthesise evidence on risk factors associated with paediatric unplanned hospital readmissions (UHRs).DesignSystematic review.Data sourceCINAHL, EMBASE (Ovid) and MEDLINE from 2000 to 2017.Eligibility criteriaStudies published in English with full-text access and focused on paediatric All-cause, Surgical procedure and General medical condition related UHRs were included.Data extraction and synthesisCharacteristics of the included studies, examined variables and the statistically significant risk factors were extracted. Two reviewers independently assessed study quality based on six domains of potential bias. Pooling of extracted risk factors was not permitted due to heterogeneity of the included studies. Data were synthesised using content analysis and presented in narrative form.ResultsThirty-six significant risk factors were extracted from the 44 included studies and presented under three health condition groupings. For All-cause UHRs, ethnicity, comorbidity and type of health insurance were the most frequently cited factors. For Surgical procedure related UHRs, specific surgical procedures, comorbidity, length of stay (LOS), age, the American Society of Anaesthesiologists class, postoperative complications, duration of procedure, type of health insurance and illness severity were cited more frequently. The four most cited risk factors associated with General medical condition related UHRs were comorbidity, age, health service usage prior to the index admission and LOS.ConclusionsThis systematic review acknowledges the complexity of readmission risk prediction in paediatric populations. This review identified four risk factors across all three health condition groupings, namely comorbidity; public health insurance; longer LOS and patients<12 months or between 13–18 years. The identification of risk factors, however, depended on the variables examined by each of the included studies. Consideration should be taken into account when generalising reported risk factors to other institutions. This review highlights the need to develop a standardised set of measures to capture key hospital discharge variables that predict unplanned readmission among paediatric patients.

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Section: Resultsmentioning

confidence: 99%

“…Age at index admission or surgery72 77 78 82 85 90 and the ASA class71 75 80 83 84 89 were cited in six differing studies. Age, however, was inconsistent across the studies.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors associated with paediatric unplanned hospital readmissions: a systematic review

et al. 2019

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“…15 For condition-specific unplanned readmissions, prevalence ranges from 19% to 31% for mental health conditions based on 12-month measurements, [16][17][18][19] from 4.5% to 38% for respiratory diseases based on 28-day to 1-year measurements [20][21][22][23][24][25] and from 0.3% to 27.8% for general surgeries based on 7-day to 1-year measurements. [26][27][28][29][30][31][32][33][34] There is limited published literature measuring all-cause paediatric unplanned hospital readmissions in Australia. Five Australian studies were identified with a focus on specific health condition-associated readmissions; these studies examined readmissions across mental health conditions, 16 asthma, 24,25 term live-born infants 35 and paediatric intensive care patients.…”

Section: Introductionmentioning

confidence: 99%

A 5-year retrospective cohort study of unplanned readmissions in an Australian tertiary paediatric hospital

Zhou

Della²,

Roberts³

et al. 2019

Aust. Health Review

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Objective The aim of this study was to examine the characteristics and prevalence of all-cause unplanned hospital readmissions at a tertiary paediatric hospital in Western Australia from 2010 to 2014. Methods A retrospective cohort descriptive study was conducted. Unplanned hospital readmission was identified using both 28- and 30-day measurements from discharge date of an index hospital admission to the subsequent related unplanned admission date. This allowed international comparison. Results In all, 73132 patients with 134314 discharges were identified. During the 5-year period, 4070 discharges (3.03%) and 3330 patients (4.55%) were identified as 30-day unplanned hospital readmissions. There were minimal differences in the rate of readmissions on Days 28, 29 and 30 (0.2%). More than 50% of readmissions were identified as a 5-day readmission. Nearly all readmissions for croup and epiglottitis occurred by Day 5; those for acute bronchiolitis and obstructive sleep apnoea requiring tonsillectomy and/or adenoidectomy occurred by Day 15 and those for acute appendicitis and abdominal and pelvic pain occurred by Day 30. Conclusion This study highlights the variability in the distribution of time intervals from discharge to readmission among diagnoses, suggesting the commonly used 28- or 30-day readmission measurement requires review. It is crucial to establish an appropriate measurement for specific paediatric conditions related to readmissions for the accurate determination of the prevalence and actual costs associated with readmissions. What is known about this topic? Unplanned hospital readmissions result in inefficient use of health resources. Australia has used 28 days to measure unplanned readmissions. However, the 30-day measurement is commonly used in the literature. Only five Australian studies were identified with a focus on readmissions associated with specific paediatric health conditions. What does this paper add? This is the first known study examining paediatric all-cause unplanned same-hospital readmissions in Western Australia. The study used both 28- and 30-day measures from discharge to unplanned readmission to allow international comparison. More than half the unplanned hospital readmissions occurred between Day 0 and Day 5 following discharge from the index admission. Time intervals from discharge date to readmission date varied for diagnosis-specific readmissions of paediatric patients. What are the implications for practitioners? Targeting the top principal index admission diagnoses identified for paediatric readmissions is critical for improvement in the continuity of discharge care delivery, health resource utilisation and associated costs. Because 52% of unplanned readmissions occurred in the first 5 days, urgent investigation and implementation of prevention strategies are required, especially when the readmission occurs on the date of discharge.

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Emergency Department Visits and Hospitalizations After Pediatric Tracheostomy

et al. 2022

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Objective: To determine factors associated with frequent emergency department (ED) visits and hospitalizations after pediatric tracheostomy.Methods: A prospective cohort of children (<18 years) with a tracheostomy placed at a tertiary children's hospital between 2015 and 2019 were followed for 24 months after index discharge. ED visits and hospitalizations were recorded to identify risk factors for frequent utilization (≥4 visits).Results: A total of 239 children required 1285 total visits to the ED or hospital after index discharge with 112 children (47%) having ≥4 visits. Respiratory-related illness was the most common reason (N = 699, 54%) followed by gastrostomy tube issues (N = 119, 9.3%). Frequent utilization was associated with Black race (

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Frequency and cause of readmissions following pediatric otolaryngologic surgery

Cited by 11 publications

References 15 publications

Risk factors associated with paediatric unplanned hospital readmissions: a systematic review

Risk factors associated with paediatric unplanned hospital readmissions: a systematic review

A 5-year retrospective cohort study of unplanned readmissions in an Australian tertiary paediatric hospital

Emergency Department Visits and Hospitalizations After Pediatric Tracheostomy

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