@Article{chd.12436,
AUTHOR = {Jeffrey H. Sacks, Michael Kelleman, Courtney McCracken, Michelle Glanville, Matthew Oster},
TITLE = {Pediatric cardiac readmissions: An opportunity for quality improvement?},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {3},
PAGES = {282--288},
URL = {http://www.techscience.com/schd/v12n3/39111},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Hospital readmissions are increasingly becoming a metric for quality in the current
landscape of changing and cost effective medicine. However, no 30-d readmission rates have
been established for pediatric cardiac medical patients in the United States. Thus, the objective
was to determine 30 d readmission rates and risk factors associated with readmission for pediatric
cardiac patients, hypothesizing that pediatric cardiac patients would have significantly higher readmission rates than their general pediatric counterparts.<br/>
<b>Design:</b> This was a retrospective cohort study.<br/>
<b>Setting:</b> The study took place at a large urban academic children’s hospital.<br/>
<b>Patients:</b> The 1124 included patients were discharged from the medical cardiology service and
had an unplanned readmission within 30 d during the period of 2012–2014.<br/>
<b>Measures:</b> Admissions, readmissions, diagnoses, demographics, weights, medications, procedures,
length of stay, were all measured.<br/>
<b>Results:</b> There were 1993 visits and 408 (20.5%) 30-d readmissions in our study. Among the
1124 patients, 219 (19.5%) had at least one 30-d readmission. Patient factors associated with
increased likelihood of 30-d readmission were younger age (median: 197.5 vs 1365.5 d,
P < .0001), lower discharge weight (6.2 v 14.5 kg, P < .0001) and greater number of diagnoses
(P < .0001). The encounter factor associated with a 30-d readmission was longer length of stay (4
vs 2 d, P < 0.0001). Factors associated with decreased readmissions were having had an electrophysiology procedure during their stay, taking an angiotensin converting enzyme inhibitor/
angiotensin receptor blocker or taking an antibiotic.<br/>
<b>Conclusions:</b> Readmissions within 30 d among pediatric cardiology patients are common. The
most common factors associated with readmissions are not likely to be modifiable but may serve
as important prognostic indicators and as a basis for counseling.},
DOI = {10.1111/chd.12436}
}