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February 8, 2014Clinical Journal of the American Society of Nephrology

Readmission within 30 days of Hospital Discharge among Children Receiving Chronic Dialysis

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Key result

Among children receiving chronic dialysis, 25% of hospital admissions were followed by a 30-day readmission, with age older than 2 years associated with lower odds of readmission (OR 0.6).

Population

1,857 children receiving chronic dialysis, age 3 months to 17 years, median age 12 years, 53.3% male…

Design

Cohort

Follow-up

30 days

Authors

TSTamar SpringelBLBenjamin L. LaskinSFSusan L. Furth

Discussion

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Overview

Elevated 30-day readmission rates in young pediatric dialysis patients support close monitoring; hypothesis-generating for targeted interventions.

Study Design

Type

Cohort (n=1,857)

Multicenter

Yes

Structured PICO

P
Population
1,857 children (accounting for 5,112 index admissions) aged 3 months to 17 years with end-stage renal disease receiving chronic dialysis, followed for 30 days post-discharge.
O
Outcome
Any-cause 30-day readmissionhard clinical

Main Result

Odds Ratio: 0.6 (95% CI 0.5–0.8)

Absolute Event Rate: 23.8% vs 32.9%

p-value: p=<0.05

A high proportion (25%) of hospital admissions in pediatric chronic dialysis patients are followed by a 30-day readmission, with higher risks observed in children under 2 years, those on hemodialysis, and those with prolonged index hospitalizations.

Limitations

  • Use of administrative data which may have coding inaccuracies
  • Type of hemodialysis access and presence of peritoneal dialysis catheter at admission could not be readily discerned
  • Dialysis vintage is unknown
  • Lack of information on patient death outside of the hospital or transplantation
  • Missing data on the underlying cause of ESRD for 30% of admissions
  • Patients readmitted to a hospital not reporting data to PHIS would be missed
  • Use of administrative data lacking specific clinical details like type of HD access or dialysis vintage
  • Missing data on underlying cause of ESRD for 30% of admissions
  • Inability to identify if readmissions were planned
  • Inability to capture readmissions to hospitals not participating in the PHIS database
  • Lack of data on out-of-hospital death or transplantation as competing risks

Cite This Study

Springel et al. (2014) conducted a cohort in End-Stage Renal Disease (ESRD) receiving chronic dialysis (n=1,857). Age > 2 years vs. Age < 2 years was evaluated on Any-cause 30-day readmission (OR 0.6, 95% CI 0.5 to 0.8, p=<0.05). Among children receiving chronic dialysis, 25% of hospital admissions were followed by a 30-day readmission, with age older than 2 years associated with lower odds of readmission (OR 0.6).

synapsesocial.com/papers/6a90155ee73a4c404fc91aa9https://doi.org/10.2215/cjn.05410513
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Also Consider

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