Risk factors for hospital readmission within 30 days: a new quality measure for children with sickle cell disease.
Risk factors for hospital readmission within 30 days: a new quality measure for children with sickle cell disease.
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医院再入院的危险因素在30天内：针对镰状细胞病儿童的新质量措施。
DOI：
10.1002/pbc.21854
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发表时间：
2009-04
影响因子：
3.2
通讯作者：
DeBaun MR
中科院分区：
文献类型：
--
作者：
Frei-Jones MJ;Field JJ;DeBaun MR
全国儿童医院协会（NACHRI）将30天内再入院作为镰状细胞病（SCD）患儿优质护理的基准。在患有SCD的儿童中，有限的数据用于确定再入院的危险因素以及它们是否可以改变。我们进行了一项回顾性队列研究，以确定再入院的危险因素。对所有一年内入院的SCD儿童进行了审查；病例定义为研究期间首次入院后30天内再次入院的SCD儿童，对照组为未再次入院的SCD儿童。我们确定了30例病例和70例对照。各组之间的人口统计数据没有差异。最常见的入院和再入院诊断是疼痛，分别占78%和70%。再入院的最大危险因素是出院30天内没有门诊血液学随访（OR 7.7, 95% CI 2.4-24.4）。哮喘诊断也是再入院的危险因素（OR 2.9, 95% CI 1.2-7.3）。需要补充氧气以维持正常血氧饱和度且出院时使用室内空气≤24小时的患者也更有可能再次入院（OR 3.3, 95% CI 1.1-9.7）。多变量分析发现缺乏门诊随访和疾病严重程度（定义为在过去12个月内入院≥3次）是再入院的预测因素（R2=0.41）。存在潜在可改变的危险因素，以降低SCD患儿因疼痛入院的再入院率。
The National Association of Children’s Hospitals (NACHRI) established hospital readmission within 30-days as a benchmark for quality care in children with Sickle Cell Disease (SCD). Among children with SCD, limited data exists to identify risk factors for readmission and whether they are modifiable. We performed a retrospective cohort study to identify risk factors for readmission. All admissions for children with SCD in a one-year period were reviewed; cases were defined as children with SCD readmitted within 30-days after their first admission during the study period and controls, children with SCD who were not readmitted. We identified 30 cases and 70 controls. No difference in demographic data was found between groups. The most common admission and readmission diagnosis was pain, 78% and 70%, respectively. The greatest risk factor for readmission was no outpatient hematology follow-up in within 30-days of discharge (OR 7.7, 95% CI 2.4–24.4). A diagnosis of asthma was also a risk factor for readmission (OR 2.9, 95% CI 1.2–7.3). Patients who required supplemental oxygen to maintain saturations in the normal range and were on room air for ≤ 24 hours at discharge were also more likely to be readmitted (OR 3.3, 95% CI 1.1–9.7). Multivariate analysis identified lack of outpatient follow-up and disease severity, defined as ≥ 3 admissions in the previous 12 months as predictors for readmission (R2=0.41). Potentially modifiable risk factors exist to decrease the rate of readmission of children with SCD admitted to the hospital for pain.
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影响因子：
20.3
作者：
Bernini, JC;Rogers, ZR;Buchanan, GR
通讯作者：
Buchanan, GR
影响因子：
12.8
作者：
Ballas, SK;Lusardi, M
通讯作者：
Lusardi, M
影响因子：
20.3
作者：
Boyd, Jessica H.;Macklin, Eric A.;DeBaun, Michael R.
通讯作者：
DeBaun, Michael R.
影响因子：
158.5
作者：
PLATT, OS;THORINGTON, BD;KINNEY, TR
通讯作者：
KINNEY, TR
影响因子：
10.1
作者：
Boyd, Jessica H.;Macklin, Eric A.;DeBaun, Michael R.
通讯作者：
DeBaun, Michael R.