title: Failure to Thrive Hospitalizations and Risk Factors for Readmission to Children's Hospitals.
abstract: OBJECTIVE
  Risk factors for failure to thrive (FTT) readmissions, including medical complexity, have not been described. We sought to characterize children hospitalized for FTT and identify risk factors associated with FTT-specific readmissions during the current era of increasing medical complexity among hospitalized children.
  
  
  METHODS
  This retrospective cohort study used the Pediatric Health Information System database of 43 freestanding children's hospitals across the United States. The cohort included children <2 years of age with index hospitalizations for FTT between 2006 and 2010. The main outcome was FTT-specific readmission within 3 years. Using Cox proportional hazards models, we assessed the association of demographic, clinical, diagnostic, and treatment characteristics with FTT-specific readmission.
  
  
  RESULTS
  There were 10 499 FTT hospitalizations, with 14.1% being readmitted for FTT within 3 years and 4.8% within 30 days. Median time to readmission was 66 days (interquartile range, 19-194 days). Nearly one-half of children (40.8%) had at least 1 complex chronic condition (CCC), with 16.4% having ≥2 CCCs. After multivariable modeling, increasing age at admission, median household income in the lowest quartile (adjusted hazard ratio, 1.23 [95% confidence interval, 1.05-1.44]), and prematurity-related CCC (adjusted hazard ratio, 1.46 [95% confidence interval, 1.16-1.86]) remained significantly associated with readmission.
  
  
  CONCLUSIONS
  Nearly one-half of children hospitalized for FTT had a CCC, and a majority of FTT-specific readmissions occurred after the traditional 30-day window. Children with prematurity-related conditions and low median household income represent unique populations at risk for FTT readmissions.
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; htpuls@cmh.edu.
authors.forename: Henry T
authors.initials: HT
authors.lastname: Puls
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Children's Hospital Association, Overland Park, Kansas; and.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hall
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;
authors.forename: Jessica
authors.initials: J
authors.lastname: Bettenhausen
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Johnson
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;
authors.forename: Christina
authors.initials: C
authors.lastname: Peacock
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Raphael
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;
authors.forename: Jason G
authors.initials: JG
authors.lastname: Newland
authors.affiliation: Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Colvin
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D005183:Failure to Thrive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data; D047928:Premature Birth / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014481:United States / Q000453:epidemiology