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Updated: Nov 22, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predictors of pediatric readmissions among patients with neurological conditions
Ryan O'Connell1,2,3, William Feaster1,2, Vera Wang1,4
1Sharon Disney Lund Medical Intelligence and Innovation Institute (MI3) at CHOC, Orange, California, USA.
Insights
Pediatric patients with neurological conditions face unplanned readmissions. Healthcare utilization is a key predictor, alongside specific conditions like hydrocephalus and central nervous system disorders.
Area of Science:
- Pediatric Neurology
- Healthcare Quality Improvement
- Health Services Research
Background:
- Unplanned readmission is a critical indicator of pediatric healthcare quality.
- Identifying novel risk factors for readmission in pediatric neurological conditions is essential.
Purpose of the Study:
- To identify novel risk factors for unplanned readmissions in pediatric patients with neurological conditions.
- To analyze the association between specific neurological diagnoses and readmission rates.
Main Methods:
- Retrieved hospitalization data for 105,834 encounters of patients under 18 with neurological conditions from 18 hospitals.
- Utilized a random intercept logistic regression model with stepwise variable selection.
- Included data on demographics, healthcare utilization, diagnoses, medications, and surgical procedures.
Main Results:
- Hydrocephalus, CNS inflammatory diseases, sleep disorders, and neuromuscular disorders were linked to higher readmission odds.
- Prior and current healthcare resource utilization, medication count, and certain surgeries significantly impacted readmission.
- The model achieved an area under the receiver operator characteristic curve (AUROC) of 0.733.
Conclusions:
- Certain pediatric neurological conditions confer a higher risk of unplanned readmission.
- Healthcare resource utilization remains a strong predictor of readmission in pediatric neurological patients, similar to the general pediatric population.
Background:
Unplanned readmission is one of many measures of the quality of care of pediatric patients with neurological conditions. In this multicenter study, we searched for novel risk factors of readmission of patients with neurological conditions.
Methods:
We retrieved hospitalization data of patients less than 18 years with one or more neurological conditions. This resulted in a total of 105,834 encounters from 18 hospitals. We included data on patient demographics, prior healthcare resource utilization, neurological conditions, number of other conditions/diagnoses, number of medications, and number of surgical procedures performed. We developed a random intercept logistic regression model using stepwise minimization of Akaike Information Criteria for variable selection.
Results:
The most important neurological conditions associated with unplanned pediatric readmissions include hydrocephalus, inflammatory diseases of the central nervous system, sleep disorders, disease of myoneural junction and muscle, other central nervous system disorder, other spinal cord conditions (such as vascular myelopathies, and cord compression), and nerve, nerve root and plexus disorders. Current and prior healthcare resource utilization variables, number of medications, other diagnoses, and certain inpatient surgical procedures were associated with changes in odds of readmission. The area under the receiver operator characteristic curve (AUROC) on the independent test set is 0.733 (0.722, 0.743).
Conclusions:
Pediatric patients with certain neurological conditions are more likely to be readmitted than others. However, current and prior healthcare resource utilization remain some of the strongest indicators of readmission within this population as in the general pediatric population.
