Hospital readmissions for newly discharged pediatric home mechanical ventilation patients.

Abstract

BACKGROUND:

Ventilator-dependent children have complex chronic conditions that put them at risk for acute illness and repeated hospitalizations.

OBJECTIVES:

To determine the 12-month incidence of and risk factors for non-elective readmission in children with chronic respiratory failure (CRF) after initiation on home mechanical ventilation (HMV) via tracheostomy.

METHODS:

A retrospective cohort study of 109 HMV patients initiated and followed at an university-affiliated children's hospital between 2003 and 2009. Patient characteristics are presented using descriptive statistics; generalized estimated equations are used to estimate adjusted odds ratios of select predictor variables for readmission.

RESULTS:

The 12-month incidence of non-elective readmission was 40%. Close to half of these readmissions occurred within the first 3 months post-index discharge. Pneumonia and tracheitis were the most common reasons for readmission; 64% were pulmonary- or tracheostomy-related. Most demographic and clinical patient characteristics were not statistically associated with non-elective readmissions. Although, a change in the child's management within 7 days before discharge was associated readmissions shortly after index discharge.

CONCLUSION:

Non-elective readmissions of newly initiated pediatric HMV patients were common and likely multifactorial. Many of these readmissions were airway-related, and some may have been potentially preventable.

• Authors: Sheila S Kun, Jeffrey D Edwards, Sally L Davidson Ward, Thomas G Keens
• Journal: Pediatric pulmonology (Pediatr Pulmonol) Vol. 47 Issue 4 Pg. 409-14 (Apr 2012) ISSN: 1099-0496 [Electronic] United States
• PMID: 21901855 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2011 Wiley Periodicals, Inc.

Topics

• Child, Preschool
• Female
• Humans
• Incidence
• Infant
• Male
• Patient Readmission (statistics & numerical data)
• Pneumonia (epidemiology)
• Respiration, Artificial (statistics & numerical data)
• Retrospective Studies
• Tracheitis (epidemiology)
• Tracheotomy (statistics & numerical data)