Related Experiment Video
Updated: Aug 22, 2025
Neutrophil Lifespan Extension with CLON-G and an In Vitro Spontaneous Death Assay
Published on: May 12, 2023
Risk Factors for Readmission Following Febrile Neutropenia in Pediatric Oncology Patients
Meghan McCormick1, Troy Richardson2,3, Louis Rapkin1
1University of Pittsburgh, Pittsburgh, PA.
Insights
Pediatric oncology patients with febrile neutropenia face readmission risks. Socioeconomic factors, not just neutrophil counts, significantly impact these readmissions.
Area of Science:
- Pediatric Oncology
- Hematology
- Health Services Research
Background:
- Febrile neutropenia is a primary cause for emergency department admissions in pediatric oncology.
- Understanding readmission factors is crucial for improving patient outcomes and healthcare resource allocation.
Purpose of the Study:
- To identify factors associated with 7-day readmission in pediatric oncology inpatients with fever and neutropenia.
- To explore the impact of socioeconomic status and clinical variables on readmission rates.
Main Methods:
- Retrospective analysis of pediatric oncology inpatients (ages 1-21) with malignancy and fever (with or without neutropenia) from 2007-2012.
- Utilized the PHIS+ database to identify 4029 index hospitalizations and evaluate 7-day readmission predictors.
- Statistical analysis included odds ratios to assess the association of various factors with readmission.
Main Results:
- 7.3% (294/4029) of index hospitalizations resulted in readmission within 7 days.
- Increased readmission odds were linked to lower median household income (OR=1.64), acute lymphoblastic leukemia diagnosis (OR=1.37), lack of anaerobic coverage (OR=1.48), and low absolute neutrophil count (<200 cells/μL) at discharge (OR=1.55).
- Readmitted patients experienced longer hospital stays and higher costs during their initial admission.
Conclusions:
- Socioeconomic factors, particularly low income, play a significant role in 7-day readmissions for pediatric oncology patients with febrile neutropenia.
- While absolute neutrophil count is important, addressing socioeconomic disparities is essential for reducing readmission rates.
- There is a concerning trend of increasing hospitalization rates for febrile neutropenia over time.
Abstract:
Febrile neutropenia is the most common reason for admission from the emergency department for pediatric oncology patients. We identified pediatric inpatients age 1 to 21 years with an International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code of malignancy and either fever with neutropenia or fever alone over a 6-year period (2007-2012) using the PHIS+ database. We evaluated factors associated with readmission within 7 days after index hospitalization. There were 4029 index hospitalizations among 2349 patients in 6 hospitals, 294 encounters (7.3%) were followed by readmission within 7 days. Factors associated with increased odds of readmission included being in the lowest quartile for median household income (odds ratio [OR]=1.64, P =0.009), diagnosis of acute lymphoblastic leukemia (OR=1.37, P =0.016), lack of anerobic coverage during index hospitalization (OR=1.48, P =0.026), and absolute neutrophil count <200 cells/μL at discharge from index hospitalizations (OR=1.55, P =0.008). Patients who required readmission had a longer median length of stay and greater hospitalization costs during the index hospitalization. There was a trend towards increasing hospitalization rates for febrile neutropenia over time. While absolute neutrophil count is incorporated into many risk stratification strategies for fever management, further work should focus on addressing socioeconomic factors which may impact readmission rates.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:27Acute Pyelonephritis I: Introduction
01:16Kidney Transplant III: Nursing Management
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...