Awerbach JD, et al. - The rate of and risk factors for 30-day hospital readmission were evaluated in children with pulmonary hypertension. As reflected by a high use of intensive care unit resources and a high 30-day readmission rate, the pediatric pulmonary hypertension population carried significant morbidity. Younger patients and those with public insurance represented particularly at-risk groups.

Methods

• The researchers analyzed Pediatric Health Information System database for patients ≤18 years old with pulmonary hypertension (International Classification of Diseases, Ninth Revision, diagnosis codes of 416.0, 416.1, 416.8, or 416.9) admitted from 2005 through 2014.
• They used a generalized hierarchical regression model to determine significant ORs and 95% CIs associated with 30-day readmission.

Results

• Inclusion criteria was met by 13,580 patients (median age 1.7 years [IQR 0.3-8.7], 45.3% with congenital heart disease).
• Throughout the study period, admissions increased 4-fold.
• In this study, associated hospital charges increased from $119 million in 2004 to $929 million in 2014.
• Admission to the intensive care unit was needed in 57.4% of patients and mechanical ventilation was required in 48.2% patients during initial admission.
• The 30-day readmission rate was 26.3%.
• During readmission, mortality was 4.2%.
• A lower hospital volume of pulmonary hypertension admissions (1.41 [1.23-1.57], P < .001) and having public insurance (1.26 [1.16-1.38], P < .001) were identified as factors increasing odds of readmission.
• Decreased odds of readmission were correlated with older age and the presence of congenital heart disease (0.86 [0.79-0.93], P < .001).