Emergency Department Visits and Readmissions among Children after Gastrostomy Tube Placement.
OBJECTIVES: To define the incidence of 30-day postdischarge emergency department (ED) visits and hospital readmissions following pediatric gastrostomy tube (GT) placement across all procedural services (Surgery, Interventional-Radiology, Gastroenterology) in 38 freestanding Children's Hospitals.
STUDY DESIGN: This retrospective cohort study evaluated patientscourse.
RESULTS: Of 15 642 identified patients, 8.6% had an ED visit within 30 days of hospital discharge, and 3.9% were readmitted through the ED with a GT-related issue. GT-related events associated with these visits included infection (27%), mechanical complication (22%), and replacement (19%). In multivariable analysis, Hispanic ethnicity, non-Hispanic black race, and the presence of ≥3 chronic conditions were independently associated with ED revisits; gastroesophageal reflux and not having a concomitant fundoplication at time of GT placement were independently associated with hospital readmission. Timing of GT placement (scheduled vs late) was not associated with either ED revisits or hospital readmission.
CONCLUSIONS: GT placement is associated with high rates of ED revisits and hospital readmissions in the first 30 days after hospital discharge. The association of nonmodifiable risk factors such as race/ethnicity and medical complexity is an initial step toward understanding this population so that interventions can be developed to decrease these potentially preventable occurrences given their importance among accountable care organizations.
Published In/Presented At
Goldin, A. B., Heiss, K. F., Hall, M., Rothstein, D. H., Minneci, P. C., Blakely, M. L., Browne, M., Raval, M. V., Shah, S. S., Rangel, S. J., Snyder, C. L., Vinocur, C. D., Berman, L., Cooper, J. N., & Arca, M. J. (2016). Emergency Department Visits and Readmissions among Children after Gastrostomy Tube Placement. The Journal of pediatrics, 174, 139–145.e2. https://doi.org/10.1016/j.jpeds.2016.03.032
Medicine and Health Sciences | Pediatrics
Department of Pediatrics