Key result
The 30-day unplanned readmission rate for pediatric neurology patients was 6.9%, with readmission significantly associated with multiple AEDs, PICU admission, and major complications (p < 0.05).
Why the study?
Hospital readmission is an important quality improvement measure that has not been well-studied in pediatric neurology.
Observational (n=923)
No
p-value: p=< 0.05
Multiple antiepileptic drugs, PICU admission, and major comorbidities are significant predictors of 7- and 30-day readmissions in pediatric neurology patients.
Potential predictors of pediatric neurology readmissions identified; leaves open whether interventions targeting them improve outcomes.
Objective Hospital readmission is an important quality improvement measure that has not been well-studied in pediatric neurology. We examined predictors of 7-day and 30-day readmissions for pediatric patients hospitalized with a neurologic diagnosis. Methods This was a retrospective study of hospital readmission rates in pediatric neurology patients admitted to a tertiary children9s hospital from January 2017 to December 2017. Inclusion criteria were age ≤18 years and a primary neurologic diagnosis on admission, with an unplanned readmission within 7 or 30 days. Demographic and clinical data were collected, including age, sex, income, insurance type, discharge occurring on a weekend, admission to the pediatric intensive care unit (PICU), use of multiple antiepileptic drugs (AEDs), and involvement of multiple subspecialties. Results There were 923 neurology admissions, and 64 readmissions within 30 days. Total unplanned readmission rate was 6.9%, with 56% (36/64) readmitted within 30 days, 44% (28/64) readmitted within 7 days, and 11% (7/64) admitted multiple times within 30 days. The most common readmission diagnosis was seizure (62%), followed by other neurologic diagnosis (21%), headache (8%), encephalitis/meningitis (7%), stroke (1%), and ataxia (1%). Readmission was significantly associated with multiple AED, PICU admission, seizure with major complication or comorbidity, and presence of a major complication or comorbidity irrespective of diagnosis (p < 0.05). Conclusions This study identifies factors associated with higher rates of readmission for pediatric neurology patients. Patients with epilepsy and chronic neurologic conditions should be targeted for future discharge-related interventions to reduce hospital readmission and ensure safe transitions from the inpatient to the outpatient setting.
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Hong et al. (2019) conducted an observational in Neurologic diagnosis (n=923). Clinical and demographic predictors (e.g., multiple AEDs, PICU admission, major complications) was evaluated on Unplanned hospital readmission within 7 or 30 days (p=< 0.05). The 30-day unplanned readmission rate for pediatric neurology patients was 6.9%, with readmission significantly associated with multiple AEDs, PICU admission, and major complications (p < 0.05).