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Pediatric readmission

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https://www.readbyqxmd.com/read/28922266/time-to-asthma-related-readmission-in-children-admitted-to-the-icu-for-asthma
#1
Sze Man Tse, Christian Samson
OBJECTIVES: To compare the time to asthma-related readmissions between children with a previous ICU hospitalization for asthma and those with a non-ICU hospitalization and to explore predictors of time to readmission in children admitted to the ICU. DESIGN: Retrospective cohort study using a pan-Canadian administrative inpatient database from April 1, 2008, to March 31, 2014. SETTING: All adult and pediatric Canadian hospitals. SUBJECTS: Children 2-17 years old with a hospitalization for asthma...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28911938/-families-experiences-and-satisfaction-with-a-pediatric-emergency-service
#2
S Perret, M Gehri, J Pluies, I Rossi, C Akre
OBJECTIVE: Today, pediatric emergency services receive a rising number of "non-urgent" cases, which are due to parental anxiety or a miscomprehension of medical explanations. The aim of this study was therefore to understand what those families experience and need when they consult in such cases, in order to respond with adapted solutions. METHODS: Semi-structured interviews and questionnaires with parents, after the consultation or in the waiting room. RESULTS: Based on the families' narratives, we present the results in six steps, which correspond to the steps they experience from the decision to go to the hospital to the consultation...
September 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28892533/association-of-guideline-adherent-antibiotic-treatment-with-readmission-of-children-with-sickle-cell-disease-hospitalized-with-acute-chest-syndrome
#3
David G Bundy, Troy E Richardson, Matthew Hall, Jean L Raphael, David C Brousseau, Staci D Arnold, Ram V Kalpatthi, Angela M Ellison, Suzette O Oyeku, Samir S Shah
Importance: Acute chest syndrome (ACS) is a common, serious complication of sickle cell disease (SCD) and a leading cause of hospitalization and death in both children and adults with SCD. Little is known about the effectiveness of guideline-recommended antibiotic regimens for the care of children hospitalized with ACS. Objectives: To use a large, national database to describe patterns of antibiotic use for children with SCD hospitalized for ACS and to determine whether receipt of guideline-adherent antibiotics was associated with lower readmission rates...
September 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28844536/us-pediatric-trauma-patient-unplanned-30-day-readmissions
#4
Krista K Wheeler, Junxin Shi, Henry Xiang, Rajan K Thakkar, Jonathan I Groner
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...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28837382/national-estimates-of-30-day-readmissions-among-children-hospitalized-for-asthma-in-the-united-states
#5
Sreenivas P Veeranki, Michael U Ohabughiro, Jacob Moran, Hemalkumar B Mehta, Bill T Ameredes, Yong-Fang Kuo, William J Calhoun
Objective Previous single-center studies have reported that up to 40% of children hospitalized for asthma will be readmitted. The study objectives are to investigate the prevalence and timing of 30-day readmissions in children hospitalized with asthma, and to identify factors associated with 30-day readmissions. Methods Data (n = 12,842) for children aged 6-18 years hospitalized for asthma were obtained from the 2013 Nationwide Readmission Database (NRD). The primary study outcome was time to readmission within 30 days after discharge attributable to any cause...
August 24, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28822673/the-financial-impact-of-a-hospital-based-care-coordination-program-for-children-with-special-health-care-needs
#6
Janine M Petitgout
Care coordination programs are important in caring for medically complex pediatric patients, particularly for children with special health care needs. This study is a retrospective financial analysis of a hospital-based care coordination program involving one procedural subgroup of children with special health care needs: those receiving pediatric tracheostomy. Hospital records were reviewed for patients who received a tracheostomy at a large Midwestern U.S. hospital from 1999 through 2015. The population was divided into two subgroups: patients who received a tracheostomy before the development of a care coordination program and patients who received a tracheostomy after enrollment in the care coordination program...
August 16, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28815624/morbidity-and-mortality-in-children-undergoing-bronchoscopy-for-foreign-body-removal
#7
Christopher A Roberts, Michele M Carr
OBJECTIVES/HYPOTHESIS: Analyze morbidity and mortality among children undergoing bronchoscopy for foreign body removal. STUDY DESIGN: Multicenter retrospective review using the American College of Surgeons Pediatric National Surgical Quality Improvement Program from 2014 and 2015. METHODS: Patients were identified using Current Procedural Terminology code 31635. Demographics, time to surgery, operative times, hospitalization time, and complications were collected...
August 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28814257/discharge-interventions-and-modifiable-risk-factors-for-preventing-hospital-readmissions-in-children-with-medical-complexity
#8
John Stephens, Kelly S Kimple, Michael J Steiner, Jay G Berry
BACKGROUND: Concerns about the costs and quality of hospital care have led to increased interest in hospital readmissions in children. Children with medical complexity account for high proportions of inpatient utilization and have a higher risk of hospital readmission. OBJECTIVE: To identify studies of discharge interventions to prevent hospital readmissions in children with medical complexity. METHODS: We conducted a search to identify studies of discharge interventions...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#9
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28792662/comparing-oncologic-outcomes-after-minimally-invasive-and-open-surgery-for-pediatric-neuroblastoma-and-wilms-tumor
#10
Brian Ezekian, Brian R Englum, Brian C Gulack, Kristy L Rialon, Jina Kim, Lindsay J Talbot, Obinna O Adibe, Jonathan C Routh, Elisabeth T Tracy, Henry E Rice
BACKGROUND: Minimally invasive surgery (MIS) has been widely adopted for common operations in pediatric surgery; however, its role in childhood tumors is limited by concerns about oncologic outcomes. We compared open and MIS approaches for pediatric neuroblastoma and Wilms tumor (WT) using a national database. METHODS: The National Cancer Data Base from 2010 to 2012 was queried for cases of neuroblastoma and WT in children ≤21 years old. Children were classified as receiving open or MIS surgery for definitive resection, with clinical outcomes compared using a propensity matching methodology (two open:one MIS)...
August 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28771405/pediatric-readmissions-after-hospitalizations-for-lower-respiratory-infections
#11
Mari M Nakamura, Alan M Zaslavsky, Sara L Toomey, Carter R Petty, Maria C Bryant, Alexandra T Geanacopoulos, Ashish K Jha, Mark A Schuster
BACKGROUND AND OBJECTIVE: Lower respiratory infections (LRIs) are among the most common reasons for pediatric hospitalization and among the diagnoses with the highest number of readmissions. Characterizing LRI readmissions would help guide efforts to prevent them. We assessed variation in pediatric LRI readmission rates, risk factors for readmission, and readmission diagnoses. METHODS: We analyzed 2008-2009 Medicaid Analytic eXtract data for patients <18 years of age in 26 states...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/28763427/safety-of-outpatient-parenteral-antimicrobial-therapy-in-children
#12
Priyanka Fernandes, Carly Milliren, Helen M Mahoney-West, Laura Schwartz, Catherine S Lachenauer, Mari M Nakamura
BACKGROUND AND OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) provides numerous benefits but may pose unique risks in children. We aimed to determine rates of OPAT antimicrobial- and intravenous-access-related complications and their associations with specific antimicrobials and type of intravenous access in pediatric patients. METHODS: Observational cohort study of patients receiving OPAT from 8/2008 to 5/2015 cared for by the Infectious Diseases service at a tertiary children's hospital...
July 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28762646/predicting-unplanned-readmissions-to-a-pediatric-cardiac-intensive-care-unit-using-predischarge-pediatric-early-warning-scores
#13
Ashley R Kroeger, Jacqueline Morrison, Andrew H Smith
OBJECTIVE: Unplanned readmission to the pediatric cardiac intensive care unit (CICU) is associated with significant morbidity and mortality. The Pediatric Early Warning Score (PEWS) predicts ward patients at risk for decompensation but has not been previously reported to identify at-risk patients with cardiac disease prior to ward transfer. This study aimed to determine whether PEWS prior to transfer may serve as a predictor of unplanned readmission to the CICU. DESIGN: All patients discharged from a tertiary children's hospital CICU from September 2012 through August 2015 were included for analysis...
August 1, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28748772/epidemiology-and-hospital-readmission-associated-with-complications-of-staphylococcus-aureus-bacteremia-in-pediatrics-over-a-25-year-period
#14
J LE, Q Dam, T Tran, A Nguyen, F C Adler-Shohet, S Kim, K Schmidt, J M Lieberman, J S Bradley
We sought to comprehensively assess the prevalence and outcomes of complications associated with Staphylococcus aureus bacteremia (SAB) in children. Secondarily, prevalence of methicillin resistance and outcomes of complications from methicillin-resistant S. aureus (MRSA) vs. methicillin-susceptible S. aureus SAB were assessed. This is a single-center cross-sectional study of 376 patients ⩽18 years old with SAB in 1990-2014. Overall, 197 (52%) patients experienced complications, the most common being osteomyelitis (33%), skin and soft tissue infection (31%), and pneumonia (25%)...
September 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28738938/minimally-invasive-incision-and-drainage-technique-in-the-treatment-of-simple-subcutaneous-abscess-in-adults
#15
Hai V Salfity, Nakul Valsangkar, Melissa Schultz, Joseph Salfity, Katie Jo Stanton-Maxey, Ben Zarzaur, David V Feliciano, Michelle R Laughlin
A minimally invasive (MI) approach using small incisions and vessel loops for drainage of simple perianal abscesses has been described in the pediatric population with decreased postoperative pain and comparable results to the traditional incision and drainage (I&D). The hypothesis was MI I&D will yield similar outcomes in adults. Patients who underwent I&D of perianal abscesses at an urban hospital from January 2008 to December 2015 were identified by Current Procedural Terminology code. Patients below 18 years of age, with inflammatory bowel diseases, or fistulae were excluded...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28728827/the-use-of-perioperative-ketorolac-in-the-surgical-treatment-of-pediatric-spontaneous-pneumothorax
#16
R Michael Dorman, George Ventro, Sarah B Cairo, Kaveh Vali, David H Rothstein
BACKGROUND: We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. METHODS: The Pediatric Health Information System database was queried for patients ages 10-16years discharged in the years 2004-2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28709646/challenge-of-balancing-duration-of-stay-and-readmissions-in-children-s-operation
#17
Heather L Short, Isaac Parakati, Kurt F Heiss, Mark L Wulkan, John F Sweeney, Mehul V Raval
BACKGROUND: Surgeons balance competing interests of minimizing duration of stay with readmissions. Complications that occur early after discharge often result in readmissions. This study examines the relationship between duration of stay, timing of complications, and readmission risk. METHODS: Cases from the 2012-2014 National Surgical Quality Improvement Project-Pediatric were organized into 30 procedural groups. Procedures where duration of stay approximated the median day of complication were identified...
July 11, 2017: Surgery
https://www.readbyqxmd.com/read/28708677/repeated-critical-illness-and-unplanned-readmissions-within-1-year-to-picus
#18
MULTICENTER STUDY
Jeffrey D Edwards, Adam R Lucas, W John Boscardin, R Adams Dudley
OBJECTIVES: To determine the occurrence rate of unplanned readmissions to PICUs within 1 year and examine risk factors associated with repeated readmission. DESIGN: Retrospective cohort analysis. SETTING: Seventy-six North American PICUs that participated in the Virtual Pediatric Systems, LLC (VPS, LLC, Los Angeles, CA). PATIENTS: Ninety-three thousand three hundred seventy-nine PICU patients discharged between 2009 and 2010...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28693849/impact-of-outpatient-management-following-appendectomy-for-acute-appendicitis-an-acs-nsqip-p-analysis
#19
Cristen N Litz, Laurie Stone, Roberta Alessi, Nebbie E Walford, Paul D Danielson, Nicole M Chandler
BACKGROUND: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. METHODS: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes...
June 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28688994/comparison-of-30-day-emergency-department-bouncebacks-after-pediatric-versus-adult-urologic-surgery
#20
Courtney L Shepard, Julian Wan
INTRODUCTION: More pediatric patients seem to present to the emergency department (ED) for non-urgent matters after urologic procedures than adult patients. Under new and expanding healthcare reform, pediatric urologists may be penalized for these visits. We compare our 30-day postoperative bounceback rates to the ED and the acuity of the concerns in these populations. MATERIALS AND METHODS: All urology consults at our institution are maintained on a prospectively tracked database...
June 20, 2017: Journal of Pediatric Urology
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