Frequency, characteristics, and outcomes of pediatric patients readmitted to the cardiac critical care unit

Intensive Care Med. 2012 Aug;38(8):1352-7. doi: 10.1007/s00134-012-2592-2. Epub 2012 May 16.

Abstract

Purpose: To describe the characteristics and outcomes of patients readmitted to a pediatric cardiac critical care unit (CCCU) from the ward within 72 h of their first discharge.

Methods: This was a retrospective analysis of data collected on patients admitted to the CCCU between January 1, 2000 and January 31, 2007. The setting was an 18-bed pediatric CCCU in a tertiary care university hospital. No interventions were performed.

Results: Among the 4,625 patients admitted to the CCCU, 112 (2.4 %) were readmitted from the ward within 72 h of their discharge. The most common cause for readmission was respiratory symptoms (42.9 %). Significant changes in the chest X-ray prior to discharge were identified retrospectively in 12.5 % of these patients. Cardiovascular symptoms were similarly frequent (40.2 %) among these patients. Nine (8 %) of the patients died during the readmission period, a rate which is considerably higher than the overall CCCU mortality rate (3.8 %) in the same period of time.

Conclusions: Respiratory reasons are the most common cause for early CCCU readmission among pediatric cardiac patients. The readmitted patients have higher rates of death compared to the overall pediatric cardiac critical care population. The development of objective predischarge scores might help planning appropriately for discharge to the ward and avoid readmission to the CCU.

MeSH terms

  • Adolescent
  • Blood Gas Analysis / statistics & numerical data
  • Cardiotonic Agents / therapeutic use
  • Child
  • Child, Preschool
  • Coronary Care Units*
  • Extracorporeal Membrane Oxygenation / statistics & numerical data
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Heart Defects, Congenital / epidemiology
  • Heart Diseases / epidemiology
  • Hospital Mortality*
  • Humans
  • Infant
  • Infant, Newborn
  • Infections / epidemiology
  • Intensive Care Units, Pediatric*
  • Lung / diagnostic imaging
  • Lung Diseases / epidemiology
  • Male
  • Nervous System Diseases / epidemiology
  • Noninvasive Ventilation / statistics & numerical data
  • Patient Readmission / statistics & numerical data*
  • Radiography
  • Retrospective Studies

Substances

  • Cardiotonic Agents