All authors: Department of Pediatrics, Hospital Sultanah Aminah Johor Bahru, Johor DT, Ministry of Health, Johor, Malaysia.
Pediatr Crit Care Med. 2020 Nov;21(11):e959-e966. doi: 10.1097/PCC.0000000000002406.
To study the rate of unplanned PICU readmission, determine the risk factors and its impact on mortality.
A single-center retrospective cross-sectional study.
Tertiary referral PICU in Johor, Malaysia.
All children admitted to the PICU over 8 years were included. Patients readmitted into PICU after the first PICU discharge during the hospitalization period were categorized into "early" (within 48 hr) and "late" (after 48 hr), and factors linked to the readmissions were identified. The mortality rate was determined and compared between no, early, and late readmission.
None.
There were 2,834 patients in the study with 70 early and 113 late readmissions. Therefore, the rate of early and late PICU readmission was 2.5% (95% CI, 1.9-3.0%) and 3.9% (95% CI, 3.2-4.7%), respectively. The median length of stay of the second PICU admission for early and late readmissions was 2.7 days (interquartile range, 1.1-7.0 d) and 3.2 days (interquartile range, 1.2-7.5 d), respectively. The majority of early and late readmissions had a similar diagnosis with their first PICU admission. Multivariable multinomial logistic regression revealed a Pediatric Index Mortality 2 score of greater than or equal to 15, chronic cardiovascular condition, and oxygen supplement upon discharge as independent risk factors for early PICU readmission. Meanwhile, an infant of less than 1 year old, having cardiovascular, other congenital and genetic chronic conditions and being discharged between 8 AM and 5 PM was an independent risk factor for late readmission. There was no significant difference in the mortality rate of early (12.9%), late (13.3%), and no readmission (10.7%).
Despite the lack of resources and expertise in lower- and middle-income countries, the rate and factors for PICU readmission are similar to those in high-income countries. However, PICU readmission has no statistically significant association with mortality.
研究计划外 PIC U 再入院率，确定危险因素及其对死亡率的影响。
单中心回顾性横断面研究。
马来西亚柔佛州的三级转诊 PIC U。
纳入在 8 年内入住 PIC U 的所有儿童。在住院期间首次 PIC U 出院后再次入住 PIC U 的患者分为“早期”（48 小时内）和“晚期”（48 小时后），并确定与再入院相关的因素。确定死亡率并比较无再入院、早期再入院和晚期再入院的死亡率。
无。
研究中有 2834 名患者，其中 70 例为早期再入院，113 例为晚期再入院。因此，早期和晚期 PIC U 再入院率分别为 2.5%（95%CI，1.9-3.0%）和 3.9%（95%CI，3.2-4.7%）。早期和晚期再入院的第二次 PIC U 住院中位时间分别为 2.7 天（四分位距，1.1-7.0 d）和 3.2 天（四分位距，1.2-7.5 d）。早期和晚期再入院的大多数患者与首次 PIC U 入院的诊断相似。多变量多项逻辑回归显示，Pediatric Index Mortality 2 评分大于或等于 15、慢性心血管疾病和出院时补充氧气是早期 PIC U 再入院的独立危险因素。同时，年龄小于 1 岁、患有心血管、其他先天性和遗传性慢性疾病以及在上午 8 点至下午 5 点之间出院是晚期再入院的独立危险因素。早期（12.9%）、晚期（13.3%）和无再入院（10.7%）的死亡率无显著差异。
尽管资源和专业知识有限，但中低收入国家的 PIC U 再入院率和危险因素与高收入国家相似。然而，PICU 再入院与死亡率无统计学显著关联。
