Rates and risk factors of unplanned 30-day readmission following general and thoracic pediatric surgical procedures

Stephanie F. Polites, Donald D. Potter, Amy E. Glasgow, Denise B. Klinkner, Christopher R. Moir, Michael B. Ishitani, Elizabeth B Habermann

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background/Purpose: Postoperative unplanned readmissions are costly and decrease patient satisfaction; however, little is known about this complication in pediatric surgery. The purpose of this study was to determine rates and predictors of unplanned readmission in a multi-institutional cohort of pediatric surgical patients. Methods: Unplanned 30-day readmissions following general and thoracic surgical procedures in children <. 18 were identified from the 2012-2014 National Surgical Quality Improvement Program- Pediatric. Time-dependent rates of readmission per 30 person-days were determined to account for varied postoperative length of stay (pLOS). Patients were randomly divided into 70% derivation and 30% validation cohorts which were used for creation and validation of a risk model for readmission. Results: Readmission occurred in 1948 (3.6%) of 54,870 children for a rate of 4.3% per 30 person-days. Adjusted predictors of readmission included hepatobiliary procedures, increased wound class, operative duration, complications, and pLOS. The predictive model discriminated well in the derivation and validation cohorts (AUROC 0.710 and 0.701) with good calibration between observed and expected readmission events in both cohorts (p. > .05). Conclusions: Unplanned readmission occurs less frequently in pediatric surgery than what is described in adults, calling into question its use as a quality indicator in this population. Factors that predict readmission including type of procedure, complications, and pLOS can be used to identify at-risk children and develop prevention strategies. Level of evidence: III.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
DOIs
StateAccepted/In press - Sep 14 2016

Fingerprint

Thoracic Surgical Procedures
Pediatrics
Patient Satisfaction
Population

Keywords

  • Pediatric surgery
  • Quality
  • Readmission

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Rates and risk factors of unplanned 30-day readmission following general and thoracic pediatric surgical procedures. / Polites, Stephanie F.; Potter, Donald D.; Glasgow, Amy E.; Klinkner, Denise B.; Moir, Christopher R.; Ishitani, Michael B.; Habermann, Elizabeth B.

In: Journal of Pediatric Surgery, 14.09.2016.

Research output: Contribution to journalArticle

Polites, Stephanie F. ; Potter, Donald D. ; Glasgow, Amy E. ; Klinkner, Denise B. ; Moir, Christopher R. ; Ishitani, Michael B. ; Habermann, Elizabeth B. / Rates and risk factors of unplanned 30-day readmission following general and thoracic pediatric surgical procedures. In: Journal of Pediatric Surgery. 2016.
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AU - Moir, Christopher R.

AU - Ishitani, Michael B.

AU - Habermann, Elizabeth B

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