Readmission characteristics of elective pediatric circumcisions using large-scale administrative data

Roth, Joshua D.; Keenan, Alison; Carroll, Aaron E.; Rink, Richard C.; Cain, Mark P.; Whittam, Benjamin; Bennett, William E.

doi:10.1016/j.jpurol.2015.10.006

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…The most traumatic complications for parents and patients are hemorrhages that require emergency surgical exploration to control bleeding and remove hematoma. 4 Recent studies have demonstrated reoperation rates as low as 0.1%, 3 but other investigations showed similar data to those found in this study – about 3 to 4.5%. ( 8 , 9 …”

Section: Discussionsupporting

confidence: 89%

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Circumcision: postoperative complications that required reoperation

Talini¹,

Antunes²,

Carvalho³

et al. 2018

Einstein (São Paulo)

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Objective To evaluate post-operative complications of circumcision requiring surgical reintervention.Methods Retrospective analysis of medical records of patients submitted to circumcision from May 1st, 2015 to May 31st, 2016.Results A total of 2,441 circumcisions were performed; in that, 1,940 using Plastibell and 501 by the classic technique. Complications requiring surgical reintervention were found in 3.27% of patients. When separated by surgical technique, 3.4% of circumcisions using Plastibell device required reoperation, as compared to 3% of conventional technique (p=0.79). Preputial stenosis was most frequently found in classic circumcision, with statistical significance (p<0.001). Bleeding was more frequent when using Plastibell device, but the difference was not statistically different (p=0.37). Patients’ age was also evaluated to investigate if this variable influenced on the postoperative outcome, but no significant difference was found.Conclusion There was no statistically significant difference when comparing complications between the different techniques performed at this hospital. Preputial stenosis was most frequently found in the classic circumcision, while bleeding was more prevalent when using Plastibell device. Patients’ age did not influence in complications.

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Section: Discussionsupporting

confidence: 89%

“…3 Some pediatric urologists consider that adolescent patients have a greater risk of postoperative bleeding, but this association has not been duly confirmed by literature. 4 …”

Section: Introductionmentioning

confidence: 99%

Circumcision: postoperative complications that required reoperation

Talini¹,

Antunes²,

Carvalho³

et al. 2018

Einstein (São Paulo)

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“…Published pediatric literature show varying rates of ED return ranging from 2.4% to 2.6% after urologic procedures [4,15] to 18.9% after appendectomy [13]. In Atlanta, at a similar tertiary care children's hospital, Arlen et al showed an overall readmission rate after urologic procedures to be 0.54% [4] compared with our 1.3% in the present study.…”

Section: Discussioncontrasting

confidence: 39%

Return to emergency department after pediatric urology procedures

Naoum

Chua

Ming

et al. 2019

Journal of Pediatric Urology

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“…The top diagnoses identified in the present study could be targeted to improve continuity of care at discharge and therefore to reduce the readmission rate. [3][4][5] Most studies in the literature use a period of 30 days to measure unplanned hospital readmissions, although some studies have used 7 days 30,45,47 to measure readmissions. Berry et al 15 found that 39% of all-cause readmissions occurred in the first 7 days after discharge and that 61.6% occurred in the first 14 days.…”

Section: Discussionmentioning

confidence: 99%

“…15 For condition-specific unplanned readmissions, prevalence ranges from 19% to 31% for mental health conditions based on 12-month measurements, [16][17][18][19] from 4.5% to 38% for respiratory diseases based on 28-day to 1-year measurements [20][21][22][23][24][25] and from 0.3% to 27.8% for general surgeries based on 7-day to 1-year measurements. [26][27][28][29][30][31][32][33][34] There is limited published literature measuring all-cause paediatric unplanned hospital readmissions in Australia. Five Australian studies were identified with a focus on specific health condition-associated readmissions; these studies examined readmissions across mental health conditions, 16 asthma, 24,25 term live-born infants 35 and paediatric intensive care patients.…”

Section: Introductionmentioning

confidence: 99%

A 5-year retrospective cohort study of unplanned readmissions in an Australian tertiary paediatric hospital

Zhou

Della²,

Roberts³

et al. 2019

Aust. Health Review

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Objective The aim of this study was to examine the characteristics and prevalence of all-cause unplanned hospital readmissions at a tertiary paediatric hospital in Western Australia from 2010 to 2014. Methods A retrospective cohort descriptive study was conducted. Unplanned hospital readmission was identified using both 28- and 30-day measurements from discharge date of an index hospital admission to the subsequent related unplanned admission date. This allowed international comparison. Results In all, 73132 patients with 134314 discharges were identified. During the 5-year period, 4070 discharges (3.03%) and 3330 patients (4.55%) were identified as 30-day unplanned hospital readmissions. There were minimal differences in the rate of readmissions on Days 28, 29 and 30 (0.2%). More than 50% of readmissions were identified as a 5-day readmission. Nearly all readmissions for croup and epiglottitis occurred by Day 5; those for acute bronchiolitis and obstructive sleep apnoea requiring tonsillectomy and/or adenoidectomy occurred by Day 15 and those for acute appendicitis and abdominal and pelvic pain occurred by Day 30. Conclusion This study highlights the variability in the distribution of time intervals from discharge to readmission among diagnoses, suggesting the commonly used 28- or 30-day readmission measurement requires review. It is crucial to establish an appropriate measurement for specific paediatric conditions related to readmissions for the accurate determination of the prevalence and actual costs associated with readmissions. What is known about this topic? Unplanned hospital readmissions result in inefficient use of health resources. Australia has used 28 days to measure unplanned readmissions. However, the 30-day measurement is commonly used in the literature. Only five Australian studies were identified with a focus on readmissions associated with specific paediatric health conditions. What does this paper add? This is the first known study examining paediatric all-cause unplanned same-hospital readmissions in Western Australia. The study used both 28- and 30-day measures from discharge to unplanned readmission to allow international comparison. More than half the unplanned hospital readmissions occurred between Day 0 and Day 5 following discharge from the index admission. Time intervals from discharge date to readmission date varied for diagnosis-specific readmissions of paediatric patients. What are the implications for practitioners? Targeting the top principal index admission diagnoses identified for paediatric readmissions is critical for improvement in the continuity of discharge care delivery, health resource utilisation and associated costs. Because 52% of unplanned readmissions occurred in the first 5 days, urgent investigation and implementation of prevention strategies are required, especially when the readmission occurs on the date of discharge.

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Readmission characteristics of elective pediatric circumcisions using large-scale administrative data

Cited by 16 publications

References 7 publications

Circumcision: postoperative complications that required reoperation

Circumcision: postoperative complications that required reoperation

Return to emergency department after pediatric urology procedures

A 5-year retrospective cohort study of unplanned readmissions in an Australian tertiary paediatric hospital

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