Table 3.
Univariate and multivariate analysis of predictors of readmission
| Univariate | Multivariate | ||||
|---|---|---|---|---|---|
|
|
|
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| Readmitted (n=668), n (%) | Not readmitted (n=16,282), n (%) | P | OR (95% CI) | P | |
| Demographics, n (%) | |||||
| Age (years), mean (SD) | 13.4 (3.2) | 13.8 (2.7) | 0.001 | 0.998 (0.963–1.034) | 0.902 |
| African−American race | 109 (18.0) | 2626 (18.1) | 0.947 | 1.144 (0.895–1.463) | 0.281 |
| Hispanic ethnicity | 76 (12.0) | 1580 (10.5) | 0.209 | ||
| Female gender | 377 (56.4) | 11,443 (70.3) | <0.001 | 0.787 (0.642–0.964) | 0.021 |
| Comorbidities, n (%) | |||||
| Obese | 139 (22.4) | 2333 (15.0) | <0.001 | 2.010 (1.588–2.544) | <0.001 |
| Pulmonary comorbidity | 234 (35.0) | 2630 (16.2) | <0.001 | 1.463 (1.157–1.850) | 0.001 |
| Cardiac comorbidity | 91 (13.6) | 1388 (8.5) | <0.001 | 1.006 (0.750–1.349) | 0.970 |
| Esophageal/GI disease | 186 (27.8) | 1539 (9.5) | <0.001 | 1.417 (1.083–1.854) | 0.011 |
| Developmental delay | 329 (49.3) | 3255 (20.0) | <0.001 | 1.637 (1.247–2.149) | <0.001 |
| Seizure disorder | 176 (26.3) | 1435 (8.8) | <0.001 | 1.381 (1.011–1.888) | 0.043 |
| Cerebral palsy | 170 (25.4) | 1431 (8.8) | <0.001 | 0.949 (0.688–1.309) | 0.749 |
| Structural CNS abnormality | 181 (27.1) | 2070 (12.7) | <0.001 | 1.236 (0.969–1.576) | 0.088 |
| Neuromuscular disorder | 307 (46.0) | 3433 (21.1) | <0.001 | 1.391 (1.090–1.776) | 0.008 |
| Preoperative steroid use | 16 (2.4) | 166 (1.0) | 0.001 | 1.166 (0.619–2.197) | 0.635 |
| Nutritional support | 143 (21.4) | 1157 (7.1) | <0.001 | 0.986 (0.711–1.367) | 0.932 |
| Hematologic disorder | 23 (3.4) | 296 (1.8) | 0.002 | 0.713 (0.386–1.315) | 0.278 |
| Congenital malformation | 330 (49.4) | 4833 (29.7) | <0.001 | 1.083 (0.871–1.348) | 0.474 |
| Childhood malignancy | 11 (1.6) | 1.0) | 0.092 | ||
| ASA-class ≥3 | 395 (59.1) | 4768 (29.3) | <0.001 | 1.513 (1.161–1.970) | 0.002 |
| Lab values, mean (SD) | |||||
| White cell count | 7.3 (2.5) | 6.9 (2.3) | <0.001 | 1.043 (1.007–1.081) | 0.019 |
| Hematocrit | 40.3 (4.2) | 39.9 (3.8) | 0.009 | 0.996 (0.971–1.021) | 0.723 |
| INR | 1.1 (0.1) | 1.1 (0.1) | 0.433 | ||
| Procedural factors | |||||
| Computer assistance, n (%) | |||||
| With CAS | 21 (5.9a) | 335 | 0.055 | 1.388 (0.807–2.388) | 0.236 |
| Without CAS | 647 (3.9b) | 15,947 | |||
| Operative time | 319 (112) | 284 (109) | <0.001 | 1.001 (1.000–1.002) | 0.018 |
| LOS | 6.4 (6.2) | 5.3 (6.8) | <0.001 | 0.992 (0.977–1.007) | 0.303 |
| Total RVUs | 66.1 (28.3) | 60.1 (26.5) | 0.017 | 1.004 (1.001–1.008) | 0.014 |
aPercent of patients with CAS who were readmitted; bPercent of patients without CAS who were readmitted; Bold values indicate significance (P<0.05). Pulmonary comorbidities include ventilator dependence, asthma, chronic lung disease, chronic oxygen support, tracheostomy, or structural pulmonary or airway abnormalities. Cardiac comorbidities include previous cardiac surgery and cardiac risk factors. ASA - American Society of Anesthesiologists; RVUs - Relative value units; CAS – Computer-assisted surgery; GI - Gastric/intestinal; CNS - Central nervous system; SD - Standard deviation; OR - Odds ratio; CI - Confidence interval; LOS - Length of stay; INR - International normalized ratio