Identifying Predictors of Hospital Readmission Following Congenital Heart Surgery through Analysis of a Multiinstitutional Administrative Database

摘要: Background Despite resource burdens associated with hospital readmission, there remains little multiinstitutional data available to identify children at risk for readmission following congenital heart surgery. Methods and Results Children undergoing surgery discharged home between January of 2011 December 2012 were identified within the Pediatric Health Information System database, a collection clinical administrative data. Patient discharges assigned derivation validation cohorts purposes predictive model design, 17 871 meeting inclusion criteria. Readmission 30 days was noted 956 (11%) cohort (n = 9104), median time 9 (interquartile range [IQR] 5–18 days). Readmissions resulted in rehospitalization length stay 4 (IQR 2–8 days) an intensive care unit (ICU) admission 36% cases. Independent perioperative predictors included Risk Adjustment Congenital Heart Surgery score 6 (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.8–3.7, P < .001) ICU least 7 (OR 1.9 CI 1.6–2.2, .001). Demographic Hispanic ethnicity 1.2, 1.1–1.4, .014) government payor status .007). Predictive performance modest among (c statistic 0.68, 0.66–0.69, .001). Conclusions Readmissions are common significant consumption. While we describe independent that may patients prior discharge, likely other unreported factors contribute surgery.