title: Hospital readmissions for newly discharged pediatric home mechanical ventilation patients.
abstract: BACKGROUND
  Ventilator-dependent children have complex chronic conditions that put them at risk for acute illness and repeated hospitalizations.
  
  
  OBJECTIVE
  To determine the 12-month incidence of and risk factors for non-elective readmission in children with chronic respiratory failure (CRF) after initiation on home mechanical ventilation (HMV) via tracheostomy.
  
  
  METHODS
  A retrospective cohort study of 109 HMV patients initiated and followed at an university-affiliated children's hospital between 2003 and 2009. Patient characteristics are presented using descriptive statistics; generalized estimated equations are used to estimate adjusted odds ratios of select predictor variables for readmission.
  
  
  RESULTS
  The 12-month incidence of non-elective readmission was 40%. Close to half of these readmissions occurred within the first 3 months post-index discharge. Pneumonia and tracheitis were the most common reasons for readmission; 64% were pulmonary- or tracheostomy-related. Most demographic and clinical patient characteristics were not statistically associated with non-elective readmissions. Although, a change in the child's management within 7 days before discharge was associated readmissions shortly after index discharge.
  
  
  CONCLUSIONS
  Non-elective readmissions of newly initiated pediatric HMV patients were common and likely multifactorial. Many of these readmissions were airway-related, and some may have been potentially preventable.
authors: Division of Pediatric Pulmonology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA 94143-0106, USA.
authors: Sheila S
authors: SS
authors: Kun
authors: Jeffrey D
authors: JD
authors: Edwards
authors: Sally L Davidson
authors: SL
authors: Ward
authors: Thomas G
authors: TG
authors: Keens
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000453:epidemiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014136:Tracheitis / Q000453:epidemiology; D014140:Tracheotomy / Q000706:statistics & numerical data