Citation

Wheeler KK, Shi J, Xiang H, Thakkar RK, Groner JI. J. Pediatr. Surg. 2018; 53(4): 765-770.

Affiliation

Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205; Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210; Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205. Electronic address: jonathan.groner@nationwidechildrens.org.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jpedsurg.2017.08.003

PMID

28844536

Abstract

PURPOSE: We sought to determine readmission rates and risk factors for acutely injured pediatric trauma patients.

METHODS: We produced 30-day unplanned readmission rates for pediatric trauma patients using the 2013 National Readmission Database (NRD).

RESULTS: In US pediatric trauma patients, 1.7% had unplanned readmissions within 30days. The readmission rate for patients with index operating room procedures was no higher at 1.8%. Higher readmission rates were seen in patients with injury severity scores (ISS)=16-24 (3.4%) and ISS ≥25 (4.9%). Higher rates were also seen in patients with LOS beyond a week, severe abdominal and pelvic region injuries (3.0%), crushing (2.8%) and firearm injuries (4.5%), and in patients with fluid and electrolyte disorders (3.9%). The most common readmission principal diagnoses were injury, musculoskeletal/integumentary diagnoses and infection. Nearly 39% of readmitted patients required readmission operative procedures. Most common were operations on the musculoskeletal system (23.9% of all readmitted patients), the integumentary system (8.6%), the nervous system (6.6%), and digestive system (2.5%).

CONCLUSIONS: Overall, the readmission rate for pediatric trauma patients was low. Measures of injury severity, specifically length of stay, were most useful in identifying those who would benefit from targeted care coordination resources. LEVEL OF EVIDENCE: This is a Level III retrospective comparative study.

Copyright © 2017 Elsevier Inc. All rights reserved.

Language: en

Keywords

Injury; Pediatric; Readmissions; Trauma