Key result
Pediatric patients with pulmonary hypertension had a 14.43% 30-day readmission rate, which was significantly higher than hospitalizations from other causes (OR 4.02).
Why the study?
Pulmonary hypertension causes significant pediatric morbidity and mortality and increases hospitalization readmissions, but risk factors and comorbidities associated with 30-day readmissions needed evaluation.
Observational (n=10,501)
Yes
Odds Ratio: 4.02 (95% CI 3.84–4.2)
p-value: p=<0.001
Pediatric pulmonary hypertension is associated with a 14.4% 30-day readmission rate, which is significantly driven by invasive mechanical ventilation, Medicaid insurance, and higher severity of illness.
Extreme loss of function identifies high-risk pediatric PH patients for readmission; supports severity-based targeting but leaves open prospective validation.
BACKGROUND AND OBJECTIVES: Pulmonary hypertension (PH) leads to significant morbidity and mortality in pediatric patients and increases the readmission rates for hospitalizations. This study evaluates the risk factors and comorbidities associated with an increase in 30-day readmissions among pediatric PH patients. METHODS: National Readmission Database (NRD) 2017 was searched for patients less than 18 years of age who were diagnosed with PH based on the International Classification of Diseases, 10th Revision (ICD-10). Statistical Package for the Social Sciences (SPSS) software v25.0 (IBM Corp., Armonk, NY) was used for statistical analysis. RESULTS: Of 5.52 million pediatric encounters, 10,501 patients met the selection criteria. The 30-day readmission rate of 14.43% (p < 0.001) was higher than hospitalizations from other causes {Odds Ratio (OR) 4.02 (3.84-4.20), p < 0.001}. The comorbidities of sepsis {OR 0.75 (0.64-0.89), p < 0.02} and respiratory infections {OR 0.75 (0.67-0.85), p < 0.001} were observed to be associated with lower 30-day readmissions. Patients who required invasive mechanical ventilation via endotracheal tube {OR 1.66 (1.4-1.96), p < 0.001} or tracheostomy tube {OR 1.35 (1.15-1.6), p < 0.001} had increased unplanned readmissions. Patients with higher severity of illness based on All Patients Refined Diagnosis Related Groups (APR-DRG) were more likely to get readmitted {OR 7.66 (3.13-18.76), p < 0.001}. CONCLUSION: PH was associated with increased readmission rates compared to the other pediatric diagnoses, but the readmission rate in this study was lower than one previous pediatric study. Invasive mechanical ventilation, Medicaid insurance, higher severity of illness, and female gender were associated with a higher likelihood of readmission within 30 days.
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Sehgal et al. (2021) conducted an observational in Pediatric Pulmonary Hypertension (n=10,501). Pulmonary hypertension vs. Hospitalizations from other causes was evaluated on 30-day readmission (OR 4.02, 95% CI 3.84-4.20, p=<0.001). Pediatric patients with pulmonary hypertension had a 14.43% 30-day readmission rate, which was significantly higher than hospitalizations from other causes (OR 4.02).
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