Readmission within 30 days of hospital discharge among children receiving chronic dialysis

Tamar Springel, Benjamin Laskin, Susan Furth

Research output: Contribution to journalArticle

Abstract

Background and objectives The hospital admission rate for children receiving chronic dialysis has been increasing over the last decade. Approximately one third of patients with ESRD age 0-19 years are readmitted to the hospital within 30 days of discharge. The objective of this study was to examine hospital readmissions among a cohort of children receiving chronic dialysis to identify factors associated with higher rates of 30-day readmission. Design, settings, participants, & measurementsAretrospective cohort of index admissionswas developed among chronic dialysis patients age 3 months to 17 years at free-standing children's hospitals reporting information to the Pediatric Hospital Information System between January 2006 and November 30, 2010, and followed until December 31, 2010. The primary outcome was any-cause 30-day readmission, and the secondary outcome was 30-day readmission for a cause similar to that of the index hospitalization. Results In this cohort, 25% of hospital admissions were followed by a readmission within 30 days. Children older than 2 years of age had a lower odds of readmission (odds ratio [OR], 0.6; 95%confidence interval [95%CI], 0.5 to 0.8). Those receiving hemodialysis had a higher risk of readmission (OR, 1.2; 95% CI, 1.0 to 1.4), and admissions.14 days were also more likely to be followed by a readmission (OR, 1.5; 95% CI, 1.1 to 2.0). Approximately 50% of the readmissions were for a similar diagnosis as the index admission; however, the specific admitting diagnosis was not associated with readmission. Conclusions A significant number of admissions among children receiving long-term dialysis are followed by readmission within 30 days. Further investigation is required to reduce the high rate of readmissions in these children.

Original languageEnglish (US)
Pages (from-to)536-542
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume9
Issue number3
DOIs
StatePublished - Mar 7 2014

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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