Clinical and Geographic Characterization of 30-Day Readmissions in Pediatric Sickle Cell Crisis XXXX .

@entity3459 @entity1 @entity3458 @entity158
BACKGROUND AND OBJECTIVES: @entity3458 ( @entity3458 ) is a @entity3459 affecting many US @entity1 that is often associated with hospital readmission. Although previous studies have reported on the clinical factors that influence readmission risk, potential geographic factors have not been fully investigated. The goal of this study was to investigate the importance of geographic risk factors and to confirm previously derived clinical risk factors that influence readmissions for @entity3458 @entity158 crises. METHODS: Retrospective analyses were performed on pediatric inpatients with sickle cell crises at a single center. Readmission rates and risk factors were assessed. Geospatial analysis was conducted on point variables that represented health service access, and multivariable logistic regression models were constructed. RESULTS: The study identified 373 @entity1 experiencing sickle cell crises, with 125 (33.5%) having at least one 30-day readmission. Age (mean difference: 2.2 years; P<0.001), length of stay (median difference: 1 day; P<.001), admission @entity158 score>7 of 10 (odds ratio [OR]: 2.21; P<0.01), discharge @entity158 score>4 of 10 (OR: 2.098; P<.01), living within 5 miles of the center's main hospital (OR: 0.573; P=.04), and >3 hospital utilizations in the previous 12 months (OR: 5.103; P<.001) were identified as potential indicators of 30-day readmission risk. Logistic regression models for 30-day readmissions yielded similar results. CONCLUSIONS: Increased age, high admission and discharge @entity158 scores, decreased length of stay, and increased hospital utilizations were found to be associated with an increased risk of readmission for sickle cell crisis. @entity1 's residence was also found to be a significant risk indicator, supporting the utility of geospatial analysis in assessing readmission risk.
