30-Day readmission rates, diagnoses, and risk factors following pediatric airway surgery

Chew, Leila; Su-Velez, Brooke M; Miller, Jesse; West, Alisha N.

doi:10.1016/j.ijporl.2020.110141

Cited by 10 publications

(10 citation statements)

References 18 publications

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“… 1 2 According to Chew et al , complications occur in 10%–65% of paediatric airway procedures. 12 The paediatric airway anatomically differs to that of adults, particularly in infants younger than 1 year old. Laryngoscopy is consequently more difficult in this age group and the view is suboptimal.…”

Section: Discussionmentioning

confidence: 99%

Injection laryngoplasty for laryngeal cleft type I in an 8-week-old infant

2022

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A laryngeal cleft is a rare anatomical deformity which is increasingly treated with injection laryngoplasty. Since diagnosis of laryngeal cleft type I is often made between 2 and 5 years of age, this treatment is rarely performed on very young children. In this case, we describe how injection laryngoplasty is performed safely on an 8-week-old child, and we illustrate its added value for the diagnostic process and for temporary symptom relief.

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Section: Discussionmentioning

confidence: 99%

Injection laryngoplasty for laryngeal cleft type I in an 8-week-old infant

2022

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“…Fourteen studies (18%) investigated factors associated with readmission or re‐presentation to an emergency department setting, and eight studies (10%) evaluated factors associated with longer hospital LOS. Reported readmission rates among included studies ranged from 20%–40%, 5,14,15,78–80 although not all studies reported readmission rates specifically due to TRAINs. Broad categories associated with readmissions included dependence on mechanical ventilation/supplemental oxygen, 5,14,78 younger age, 5,14 number of medical comorbidities, 5 administration of corticosteroids, 14 and changes in medical management preceding discharge from the hospital 15 .…”

Section: Resultsmentioning

confidence: 99%

Diagnosis, management, and outcomes of pediatric tracheostomy‐associated infections: A scoping review

Morrison

Hassan

Kysh

et al. 2022

Pediatric Pulmonology

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Background: Children with tracheostomy are frequently admitted to the hospital for tracheostomy-associated respiratory infections (TRAINs). However, there remains a paucity of evidence to direct the diagnosis, treatment, and prevention of TRAINs. An important first step to addressing this knowledge gap is to synthesize existing data regarding TRAINs to inform current practice and facilitate innovation. Data Sources: We searched PubMed, Embase, Cochrane Library, CINAHL, and Web of Science from inception to October 2020. Original research articles and published abstracts including children and young adults 0-21 years of age with tracheostomy were included. Included studies assessed the clinical definitions of and risk factors for TRAINs, microbiologic epidemiology and colonization of tracheostomies, and treatment and outcomes of TRAINs. Data Synthesis: Out of 5755 studies identified in the search, 78 full-text studies were included in the final review. A substantial number of studies focused on the detection of specific pathogens in respiratory cultures including Pseudomonas aeruginosa. Several different definitions of TRAIN including clinical, microbiologic, and laboratory testing results were utilized; however, no uniform set of criteria were identified. The few studies focused on treatment and prevention of TRAIN emphasized the role of empiric antimicrobial therapy and the use of inhaled antibiotics. Conclusions: Despite a growing number of research articles studying TRAINs, there is a paucity of prospective interventional trials to guide the diagnosis, treatment, and prevention of respiratory disease in this vulnerable population. Future research should include studies of interventions designed to improve short-and long-term respiratory-related outcomes of children with tracheostomy.

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“…We found a low median household income, ALL diagnosis, lack of anaerobic coverage with clindamycin or metronidazole during the index hospitalization and ANC <200 cells/μL at index hospitalization discharge were associated with increased odds of readmission within 7 days. An inverse relationship between socioeconomic status and risk of readmission has been described in other pediatric disease groups as well 10–12. In a study of hospital-level factors associated with return visit rates and return visits with admission, Pittsenbarger et al13 found that hospitals with the highest rates of these outcomes were more likely to serve populations with lower median household incomes.…”

Section: Discussionmentioning

confidence: 97%

“…An inverse relationship between socioeconomic status and risk of readmission has been described in other pediatric disease groups as well. [10][11][12] In a study of hospital-level factors associated with return visit rates and return visits with admission, Pittsenbarger et al 13 found that hospitals with the highest rates of these outcomes were more likely to serve populations with lower median household incomes. Proposed factors contributing to this relationship may include lack of access to outpatient follow-up leading to delays in care and therefore presentation with more severe illness.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Readmission Following Febrile Neutropenia in Pediatric Oncology Patients

McCormick

Richardson

Rapkin

et al. 2022

Journal of Pediatric Hematology/Oncology

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Febrile neutropenia is the most common reason for admission from the emergency department for pediatric oncology patients. We identified pediatric inpatients age 1 to 21 years with an International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code of malignancy and either fever with neutropenia or fever alone over a 6-year period (2007-2012) using the PHIS+ database. We evaluated factors associated with readmission within 7 days after index hospitalization. There were 4029 index hospitalizations among 2349 patients in 6 hospitals, 294 encounters (7.3%) were followed by readmission within 7 days. Factors associated with increased odds of readmission included being in the lowest quartile for median household income (odds ratio [OR] = 1.64, P = 0.009), diagnosis of acute lymphoblastic leukemia (OR = 1.37, P = 0.016), lack of anerobic coverage during index hospitalization (OR = 1.48, P = 0.026), and absolute neutrophil count <200 cells/μL at discharge from index hospitalizations (OR = 1.55, P = 0.008). Patients who required readmission had a longer median length of stay and greater hospitalization costs during the index hospitalization. There was a trend towards increasing hospitalization rates for febrile neutropenia over time. While absolute neutrophil count is incorporated into many risk stratification strategies for fever management, further work should focus on addressing socioeconomic factors which may impact readmission rates.

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30-Day readmission rates, diagnoses, and risk factors following pediatric airway surgery

Cited by 10 publications

References 18 publications

Injection laryngoplasty for laryngeal cleft type I in an 8-week-old infant

Injection laryngoplasty for laryngeal cleft type I in an 8-week-old infant

Diagnosis, management, and outcomes of pediatric tracheostomy‐associated infections: A scoping review

Risk Factors for Readmission Following Febrile Neutropenia in Pediatric Oncology Patients

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