Incidence and risk factors for readmission to a paediatric intensive care unit

Abstract

Background: Unscheduled readmission to a paediatric intensive care unit can lead to unfavourable patient outcomes. Therefore, determining the incidence and risk factors is important. Previous studies on such readmissions have only focused on the first 48 hours after discharge and described the relative risk factors as unmodifiable.Aim: To identify the incidence and risk factors of unscheduled readmission to a paediatric intensive care unit within 7 days of discharge.Design: This was a retrospective observational study.Methods: Our study population comprised consecutive patients admitted to the paediatric intensive care unit of our tertiary hospital in Japan in 2012 to 2016. We determined the incidence of unscheduled readmission to the unit within 7 days of discharge and identified potential risk factors using multivariable logistic regression analysis.Results: Among the 2432 admissions (1472 patients), 60 admissions (2.5%, 44 patients) were followed by ≥1 unscheduled readmission. The median time to readmission was 3.5 days. The most common causes for readmission were respiratory issues and cardiovascular symptoms. The significant risk factors for readmission within 7 days of discharge were unscheduled initial admission (odds ratio [OR]: 3.02; 95% confidence interval [CI:] 1.45-6.31), admission from a general ward (OR: 5.13; 95% CI: 1.75-15.0), and withdrawal syndrome during the initial stay (OR: 3.95; 95%

Perfil De Crianças E Adolescentes Que Apresentaram Deterioração Clínica Em Um Contexto Hospitalar Pediátrico Do Município De Feira De Santana – Ba

“…Os escores de alerta precoce não substituem o julgamento e a habilidade clínica do profissional, mas podem ajudar a sistematizar e auxiliar a avaliação (DIFONZO, 2019). Sendo assim, o uso de escores de alerta objetiva melhorar a prática assistencial e a escolha de cuidados adequados a crianças em iminência de deterioração clínica (KONISHI et al, 2019).…”

Impacto De Um Sistema De Reconhecimento Precoce De Deterioração Clínica Pediátrica

“…Entretanto, reinternações em UTI podem ser benéficas para o paciente na prevenção de agravos e piora clínica. (18) Ainda em referência ao impacto do SRP no serviço, destaca-se redução das chamadas para avaliação médica pelos enfermeiros e nas intervenções pela equipe. Há registros de que os escores pediátricos de alerta precoce podem proporcionar empoderamento aos enfermeiros, por se sentirem mais capazes em avaliar melhor o paciente crítico e discutir o caso com o médico, (19) o que pode ter contribuído para redução desses indicadores após a implantação do SRP na rotina de avaliação.…”

What's in this issue

“…Unplanned readmissions to a PICU have worse outcomes, 6 and being able to identify children “at risk” for readmission can help us target these children and potentially impact outcomes. Konishi and colleagues 7 investigated the incidence and risk factors for readmission to PICU in a single Japanese unit within 7 days of discharge over a 4‐year period. They found that only 2.5% of children were readmitted to PICU, with a median readmission time of 3.5 days post‐discharge.…”