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Going back for more: an evaluation of clinical outcomes and characteristics of readmissions to a pediatric intensive care unit.
Pediatr Crit Care Med. 2007 Jul; 8(4):343-7; CEU quiz 357.PC

Abstract

OBJECTIVE

To determine mortality, length of stay, and factors associated with readmissions to the pediatric intensive care unit (PICU).

DESIGN

A retrospective analysis of prospectively collected data.

SETTING

A 16-bed medical-surgical tertiary PICU and a coexisting 15-bed pediatric cardiac intensive care unit.

PATIENTS

All admissions from July 1, 1998, through June 30, 2004.

INTERVENTIONS

None.

MEASUREMENTS AND RESULTS

Of 8,885 total eligible admissions, 711 (8%) were readmissions to the PICU. The median age of the overall cohort was 35.2 months (interquartile range, 5.5-128.2). Readmitted patients were younger (10.4 vs. 37.7 months, p < .01), had greater severity of illness (p < .01), and were more likely to be admitted emergently (p < .01), in comparison with single admissions. In multivariate analyses, readmitted patients had a trend toward higher odds of mortality (odds ratio, 1.39; 95% confidence interval, 0.98-1.98) and stayed 2.96 days longer in the PICU (95% confidence interval, 1.98-3.94) compared with single admissions to the PICU. Factors independently associated with PICU readmission were infant age (odds ratio, 1.98; 95% confidence interval, 1.57-2.49), emergent admission (odds ratio, 2.21; 95% confidence interval, 1.78-2.77), illness severity (odds ratio, 1.03; 95% confidence interval, 1.01-1.04), and time of the year between July and September (odds ratio, 1.52; 95% confidence interval, 1.20-1.93). A diagnosis of trauma was associated with low likelihood of PICU readmission (odds ratio, 0.30; 95% confidence interval, 0.18-0.50).

CONCLUSIONS

Patients readmitted to the PICU during the same hospitalization have significantly adverse outcomes. The study highlights important factors associated with PICU readmissions that can be incorporated into efforts to reduce mortality and resource utilization associated with readmission of critically ill children.

Authors+Show Affiliations

Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA. fodetola@med.umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17545926

Citation

Odetola, Folafoluwa O., et al. "Going Back for More: an Evaluation of Clinical Outcomes and Characteristics of Readmissions to a Pediatric Intensive Care Unit." Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol. 8, no. 4, 2007, pp. 343-7; CEU quiz 357.
Odetola FO, Clark SJ, Dechert RE, et al. Going back for more: an evaluation of clinical outcomes and characteristics of readmissions to a pediatric intensive care unit. Pediatr Crit Care Med. 2007;8(4):343-7; CEU quiz 357.
Odetola, F. O., Clark, S. J., Dechert, R. E., & Shanley, T. P. (2007). Going back for more: an evaluation of clinical outcomes and characteristics of readmissions to a pediatric intensive care unit. Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 8(4), 343-7; CEU quiz 357.
Odetola FO, et al. Going Back for More: an Evaluation of Clinical Outcomes and Characteristics of Readmissions to a Pediatric Intensive Care Unit. Pediatr Crit Care Med. 2007;8(4):343-7; CEU quiz 357. PubMed PMID: 17545926.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Going back for more: an evaluation of clinical outcomes and characteristics of readmissions to a pediatric intensive care unit. AU - Odetola,Folafoluwa O, AU - Clark,Sarah J, AU - Dechert,Ronald E, AU - Shanley,Thomas P, PY - 2007/6/5/pubmed PY - 2007/8/31/medline PY - 2007/6/5/entrez SP - 343-7; CEU quiz 357 JF - Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies JO - Pediatr Crit Care Med VL - 8 IS - 4 N2 - OBJECTIVE: To determine mortality, length of stay, and factors associated with readmissions to the pediatric intensive care unit (PICU). DESIGN: A retrospective analysis of prospectively collected data. SETTING: A 16-bed medical-surgical tertiary PICU and a coexisting 15-bed pediatric cardiac intensive care unit. PATIENTS: All admissions from July 1, 1998, through June 30, 2004. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Of 8,885 total eligible admissions, 711 (8%) were readmissions to the PICU. The median age of the overall cohort was 35.2 months (interquartile range, 5.5-128.2). Readmitted patients were younger (10.4 vs. 37.7 months, p < .01), had greater severity of illness (p < .01), and were more likely to be admitted emergently (p < .01), in comparison with single admissions. In multivariate analyses, readmitted patients had a trend toward higher odds of mortality (odds ratio, 1.39; 95% confidence interval, 0.98-1.98) and stayed 2.96 days longer in the PICU (95% confidence interval, 1.98-3.94) compared with single admissions to the PICU. Factors independently associated with PICU readmission were infant age (odds ratio, 1.98; 95% confidence interval, 1.57-2.49), emergent admission (odds ratio, 2.21; 95% confidence interval, 1.78-2.77), illness severity (odds ratio, 1.03; 95% confidence interval, 1.01-1.04), and time of the year between July and September (odds ratio, 1.52; 95% confidence interval, 1.20-1.93). A diagnosis of trauma was associated with low likelihood of PICU readmission (odds ratio, 0.30; 95% confidence interval, 0.18-0.50). CONCLUSIONS: Patients readmitted to the PICU during the same hospitalization have significantly adverse outcomes. The study highlights important factors associated with PICU readmissions that can be incorporated into efforts to reduce mortality and resource utilization associated with readmission of critically ill children. SN - 1529-7535 UR - https://www.unboundmedicine.com/medline/citation/17545926/Going_back_for_more:_an_evaluation_of_clinical_outcomes_and_characteristics_of_readmissions_to_a_pediatric_intensive_care_unit_ L2 - https://doi.org/10.1097/01.PCC.0000269400.67463.AC DB - PRIME DP - Unbound Medicine ER -