Wheeler Krista K, Shi Junxin, Xiang Henry, Thakkar Rajan K, Groner Jonathan I
Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205; Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205.
Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205; Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210.
J Pediatr Surg. 2018 Apr;53(4):765-770. doi: 10.1016/j.jpedsurg.2017.08.003. Epub 2017 Aug 7.
We sought to determine readmission rates and risk factors for acutely injured pediatric trauma patients.
We produced 30-day unplanned readmission rates for pediatric trauma patients using the 2013 National Readmission Database (NRD).
In US pediatric trauma patients, 1.7% had unplanned readmissions within 30days. The readmission rate for patients with index operating room procedures was no higher at 1.8%. Higher readmission rates were seen in patients with injury severity scores (ISS)=16-24 (3.4%) and ISS ≥25 (4.9%). Higher rates were also seen in patients with LOS beyond a week, severe abdominal and pelvic region injuries (3.0%), crushing (2.8%) and firearm injuries (4.5%), and in patients with fluid and electrolyte disorders (3.9%). The most common readmission principal diagnoses were injury, musculoskeletal/integumentary diagnoses and infection. Nearly 39% of readmitted patients required readmission operative procedures. Most common were operations on the musculoskeletal system (23.9% of all readmitted patients), the integumentary system (8.6%), the nervous system (6.6%), and digestive system (2.5%).
Overall, the readmission rate for pediatric trauma patients was low. Measures of injury severity, specifically length of stay, were most useful in identifying those who would benefit from targeted care coordination resources.
This is a Level III retrospective comparative study.
我们试图确定急性受伤的儿科创伤患者的再入院率及风险因素。
我们利用2013年国家再入院数据库（NRD）得出儿科创伤患者30天内的非计划再入院率。
在美国儿科创伤患者中，1.7%在30天内有非计划再入院情况。接受首次手术室手术的患者再入院率为1.8%，并未更高。损伤严重程度评分（ISS）为16 - 24分的患者（3.4%）及ISS≥25分的患者（4.9%）再入院率更高。住院时间超过一周的患者、严重腹部和盆腔区域损伤患者（3.0%）、挤压伤患者（2.8%）和火器伤患者（4.5%），以及患有液体和电解质紊乱的患者（3.9%）再入院率也更高。最常见的再入院主要诊断为损伤、肌肉骨骼/皮肤诊断和感染。近39%的再入院患者需要再次进行手术操作。最常见的是肌肉骨骼系统手术（占所有再入院患者的23.9%）、皮肤系统手术（8.6%）、神经系统手术（6.6%）和消化系统手术（2.5%）。
总体而言，儿科创伤患者的再入院率较低。损伤严重程度指标，尤其是住院时间，对于确定哪些患者将从有针对性的护理协调资源中受益最为有用。
这是一项III级回顾性比较研究。
