Risk Factors Associated With Readmission After Pediatric Cardiothoracic Surgery

摘要: Background Approximately 10% to 20% of children are readmitted congenital heart surgery. Readmissions now being viewed by payers as preventable complications the original surgery or hospitalization, and there have been proposals insurance agencies deny coverage additional expenses incurred readmission. With hopes reduce potential impact, we analyzed patients undergoing at our institution in order identify risk factors for Methods We performed a retrospective cohort study 685 who underwent Children's Healthcare Atlanta between January 1, 2009 December 31, 2009, were subsequently discharged. Readmission was defined an admission within 30 days discharge. Demographic, preoperative, operative, postoperative variables evaluated. Univariate comparisons made readmission non-readmission groups, multivariate Poisson regression analysis Results There 74 readmissions 70 patients. Reasons included effusive, pleural pericardial (19, 26%), gastrointestinal (18, 24%), respiratory (4, 5%), infectious (14, 19%), cardiac (11, 15%), other (8, 11%) complications. In non-readmitted patients, significant demographic younger age, lower weight, Hispanic ethnicity group. Significant preoperative genetic anomaly, failure thrive, mechanical ventilation. operative risk-adjusted score, nasogastric feeds discharge, palliated physiology, longer intensive care unit stay, hospital stay. analysis, (relative [RR] 1.86; 95% confidence interval [CI] 1.10 3.12; p = 0.019], thrive (RR 2.88; CI 1.53 5.40; 0.001), length stay greater than 10 4.24; 2.26 7.96; Conclusions Potential after identified. Hopefully, altering discharge process early these high-risk can minimize impact