The risk factors associated with hospital readmissions following pediatric neurosurgery are postoperative complications and specific surgical procedure.

‘Postoperative infections increase the risk of unplanned hospital readmission after pediatric neurosurgery.
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Hospital readmission rates are often used to determine the quality of treatment received by patients. The authors undertook this study to identify baseline readmission rates for a variety of pediatric neurosurgical procedures and to determine what risk factors lead to patient readmission in this population. 




As the title suggests, the authors pulled data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) Pediatric database. This database contains prospectively collected patient data from 50 participating hospitals; previous studies of readmission focused on data from single institutions. Eligible for the study were 9,799 neurosurgical procedures performed in patients younger than 18 years old. Of these procedures, 1,098 (11.2%) were followed by an unplanned hospital readmission within 30 days.
The authors examined relationships between unplanned readmissions and patient demographics, patient comorbidities, preoperative lab values, types of primary surgery undergone during the hospital stay, postoperative complications, and operation and hospital variables (such as the need for transfusion, the length of hospital stay, or whether the patient was admitted via the emergency department). Both univariate and multivariate analyses were performed.
The overall hospital readmission rate was 11.2%, and the time between the primary surgical procedure and readmission was 14.04 ± 7.74 days (mean ± standard deviation).
The four surgical procedures associated with the highest rates of readmission included the following: CSF shunt revision (17.3%), repair of a myelomeningocele larger than 5 cm in diameter (15.4%), CSF shunt placement (14.1%), and craniectomy to remove an infratentorial tumor (13.9%).
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Other independent risk factors for hospital readmission that were identified include postoperative pneumonia, urinary tract infection, sepsis, Native American race, long-term steroid use, need for oxygen supplementation or nutritional support, seizure disorders, and long operative times.
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When asked, the corresponding author, Dr. Brandon Rocque said, "The importance of this study is the realization that most of the factors that increase the risk of readmission cannot be controlled by physicians or hospitals. We must be careful using readmission as a way to measure the quality of care. Counting a readmission as evidence of lower quality care has the potential to unfairly judge a health system."
Source-Newswise