Identifying Risk Factors for Emergency Department Return and Readmission After Pediatric Orthopaedic Surgery: A...

Area of Science:

• Pediatric Orthopaedic Surgery
• Healthcare Outcomes Research
• Health Services Research

Background:

• Unplanned returns to the emergency department (RTED) and hospital readmissions after surgery represent significant healthcare burdens.
• These events may indicate gaps in patient care quality and postoperative management.
• Identifying risk factors is crucial for improving patient outcomes and optimizing resource allocation.

Purpose of the Study:

• To identify risk factors associated with RTED and unplanned readmissions following pediatric orthopaedic surgery.
• To analyze the impact of patient demographics, insurance status, and surgical procedure type on postoperative outcomes.

Main Methods:

• Retrospective cohort study of pediatric patients (<18 years) undergoing orthopaedic surgery (2017-2023).
• Data included demographics, insurance, BMI, language, and procedure complexity (work relative value units).
• Logistic regression analyses identified predictors for RTED and readmission at 7, 30, and 90 days.

Main Results:

• Medicaid insurance was associated with increased odds of 30-day and 90-day RTED and 90-day readmission.
• Hispanic ethnicity linked to 90-day RTED; Black or African American race linked to 7-day and 30-day readmission.
• Infection and soft tissue reconstruction surgeries associated with 7-day RTED; spine deformity surgery associated with 30-day and 90-day readmission.

Conclusions:

• Medicaid insurance status and specific procedures (infection, spine deformity, soft tissue reconstruction) identify high-risk pediatric surgical patients.
• Findings highlight the need for targeted postoperative support programs to reduce adverse events.
• Proactive interventions can mitigate risks and improve outcomes for vulnerable pediatric surgical populations.