Citation

Wheeler KK, Shi J, Nordin AB, Xiang H, Groner JI, Fabia R, Thakkar RK. J. Burn Care Res. 2018; 39(1): 73-81.

Affiliation

From the *Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH; †Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH; ‡Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH; and §The Ohio State University College of Medicine, Columbus, OH.

Copyright

(Copyright © 2018, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/BCR.0000000000000596

PMID

28661983

Abstract

The objective of the study was to determine unscheduled 30-day readmission rates for pediatric burn patients and to identify readmission reasons. We used the 2013 to 2014 National Readmission Database to produce 30-day all-cause unscheduled readmission rates by patient and hospital characteristics. Readmission risk factors were evaluated with multivariable logistic regression. An estimated 11,940 U.S. pediatric burn patients were discharged in January to November 2013 and 2014, and 325 had unscheduled readmissions within 30 days (2.7%; 95% confidence interval [CI], 1.5-3.9). This rate is higher than that seen in pediatric trauma patients (1.7%; P = 0.04]. Higher rates were seen in children with TBSA burned ≥ 10% (4.1%; 95% CI, 2.3-6.0) and patients with third-degree burns (5.5%; 95% CI, 1.4-9.6). The majority (86%) had index admissions in hospitals treating 100 or more burn patients annually, and 98% returned to the same hospital. Over two-thirds had an operating room procedure during their readmission; 15% had infections. The highest adjusted odds of readmission (AOR = 2.7; 95% CI, 1.7-4.2) was for patients with third-degree burns. When compared with patients with lengths of stay (LOS) of 1 day, those with LOS of 2 to 3 days had a higher odds (AOR = 1.7; 95% CI, 1.03-2.9), but the AOR was not different for those with LOS > 3 days. TBSA, index operating room procedure, and patient residence were associated with readmission. This national dataset enhances our ability to predict patients at risk for unscheduled readmission and to plan for appropriate patient discharge, potentially reducing readmissions.

Language: en