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Frequency, Characteristics, and Outcomes of Patients Requiring Early PICU Readmission

Eleanor A Sharp1, Li Wang2, Matt Hall3

  • 1Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Hospital Pediatrics
|July 21, 2023
PubMed

Insights

Early readmission to the pediatric intensive care unit (PICU) is uncommon but linked to worse outcomes. Patients with complex chronic conditions (CCC) face the highest risk of PICU readmission.

Area of Science:

  • Pediatric critical care medicine
  • Health services research

Background:

  • Readmission to the pediatric intensive care unit (PICU) is associated with adverse patient outcomes.
  • Understanding factors contributing to early PICU readmission within the same hospitalization is crucial for improving care.

Purpose of the Study:

  • To determine the prevalence of early PICU readmission.
  • To identify patient and clinical factors associated with early PICU readmission.

Main Methods:

  • Retrospective analysis of 389,219 PICU admissions across 48 children's hospitals (2016-2019).
  • Definition of early readmission: return to PICU within 2 days of floor transfer during the same hospitalization.
  • Generalized linear mixed models used to assess associations with patient/clinical variables, including complex chronic conditions (CCC).

Main Results:

  • The early PICU readmission rate was 2.5%.
  • Highest odds of readmission were associated with having ≥4 CCCs (aOR 4.2), parenteral nutrition (aOR 2.3), and ventriculoperitoneal shunts (aOR 1.9).
  • Factors decreasing readmission odds included extracorporeal membrane oxygenation (aOR 0.4) and cardiopulmonary resuscitation (aOR 0.8).
  • Early readmissions correlated with longer length of stay and increased mortality (aOR 1.7).

Conclusions:

  • Early PICU readmissions, while infrequent, significantly worsen clinical outcomes.
  • Patients with medical complexity and technology dependence are particularly vulnerable to early readmission.
Abstract

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