Allergy Asthma Respir Dis.  2014 May;2(2):128-133. 10.4168/aard.2014.2.2.128.

Readmission risk factors for children admitted to pediatric intensive care unit with respiratory tract disease

• Chung WJ
• Yoon DH
• Lee EG
• Bang KW
• Kim HS
• Chun YH
• Yoon JS
• Kim HH
• Kim JT
• Lee JS

• KMID: 2261748
• DOI: http://doi.org/10.4168/aard.2014.2.2.128

Abstract

PURPOSE
Children admitted to pediatric intensive care unit (PICU) with respiratory tract disease, often have a tendency to be readmitted to PICU with disease progression. We studied the risk factors for readmission to PICU, with respiratory disease progression.
METHODS
Among 286 children admitted to Seoul St. Mary's Hospital PICU from April 2009 to March 2012, 129 children admitted with respiratory tract disease were enrolled. We grouped the children readmitted to PICU with respiratory tract disease progression within 2 weeks (readmission group), and the others (control group). We compared basic and respiratory tract disease characteristics at initial PICU admission between them, by retrospective chart review.
RESULTS
Among 129 children, 8 were included in the readmission group, and 121 in the control group. Mortality and underlying disease incidence were higher in the readmission group (P=0.003 and P=0.033, respectively). The readmission group showed higher parenchymal lung disease incidence, and lower initial saturation by pulse oxymeter (SpO2)/fraction of inspiratory oxygen (FiO2), despite underlying disease influence (P=0.035 and P=0.041, respectively). Logistic regression on the underlying disease and respiratory variables showed no single factor with a significantly independent influence on readmission, but parenchymal lung disease had more independent influence.
CONCLUSION
For PICU readmission with respiratory tract disease progression, parenchymal lung disease and lower initial SpO2/FiO2 can be a risk factor despite underlying disease influence. Underlying disease and each respiratory characteristic were not significantly independent risk factors, suggesting a correlation of factors. But, parenchymal lung disease can be a more independent risk factor.

Keyword

Risk factors; Patient readmission; Respiratory tract disease; Pediatric intensive care unit

MeSH Terms

Child*
Disease Progression
Humans
Incidence
Intensive Care Units*
Logistic Models
Lung Diseases
Mortality
Oxygen
Patient Readmission
Respiratory Tract Diseases*
Retrospective Studies
Risk Factors*
Seoul
Oxygen

Figure

• 

  Fig. 1 Outline of participants of our study. Among 286 patients admitted to pediatric intensive care unit (PICU), 129 admitted with respiratory tract disease were enrolled. There was no patient died in first PICU admission. Of course, 8 patients readmitted to PICU with respiratory tract disease progression within 2 weeks were compared with the other 121 patients for clinical characteristics.

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