Characteristics and predictors of 7- and 30-day hospital readmissions to pediatric neurology. (16th April 2019)

• Record Type: Journal Article
• Authors: Hong, Annie; Shah, Yash; Singh, Kanwaljit; Karkare, Shefali; Kothare, Sanjeev
• Is Part Of: Neurology. Volume 92:Number 16(2019)
• Publication Date: 2019-04-16
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000007280
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: Hospital readmission is an important quality improvement measure that has not been well-studied in pediatric neurology. We examined predictors of 7-day and 30-day readmissions for pediatric patients hospitalized with a neurologic diagnosis. Methods: This was a retrospective study of hospital readmission rates in pediatric neurology patients admitted to a tertiary children's hospital from January 2017 to December 2017. Inclusion criteria were age ⩽18 years and a primary neurologic diagnosis on admission, with an unplanned readmission within 7 or 30 days. Demographic and clinical data were collected, including age, sex, income, insurance type, discharge occurring on a weekend, admission to the pediatric intensive care unit (PICU), use of multiple antiepileptic drugs (AEDs), and involvement of multiple subspecialties. Results: There were 923 neurology admissions, and 64 readmissions within 30 days. Total unplanned readmission rate was 6.9%, with 56% (36/64) readmitted within 30 days, 44% (28/64) readmitted within 7 days, and 11% (7/64) admitted multiple times within 30 days. The most common readmission diagnosis was seizure (62%), followed by other neurologic diagnosis (21%), headache (8%), encephalitis/meningitis (7%), stroke (1%), and ataxia (1%). Readmission was significantly associated with multiple AED, PICU admission, seizure with major complication or comorbidity, and presence of a major complication or comorbidity irrespective of diagnosis ( p < 0.05). Conclusions: This study identifies factors associated with higher rates of readmission for pediatric neurology patients. Patients with epilepsy and chronic neurologic conditions should be targeted for future discharge-related interventions to reduce hospital readmission and ensure safe transitions from the inpatient to the outpatient setting.