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  • Author or Editor: Kristie Q. Liux
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Pediatric patients with malignant brain tumor treated at children’s hospitals: association with fewer unplanned readmissions

Kristie Q. Liu, Shivani D. Rangwala, Talia A. Wenger, Mmerobasi U. Kanu, Jane S. Han, Li Ding, William J. Mack, Mark D. Krieger, and Frank J. Attenello

OBJECTIVE

小儿原发性脑瘤是铅ing cause of death among childhood cancers. Guidelines recommend specialized care with a multidisciplinary team and focused treatment protocols to optimize outcomes in this patient population. Furthermore, readmission is a key metric of patient outcomes and has been used to inform reimbursement. However, no prior study has analyzed national database–level records to evaluate the role of care in a designated children’s hospital following pediatric tumor resection and its impact on readmission rates. The goal of this study was to investigate whether treatment at a children’s hospital rather than a nonchildren’s hospital has a significant effect on outcome.

开云体育世界杯赔率

再入院全国数据库记录2010 to 2018 were analyzed retrospectively to evaluate the effect of hospital designation on patient outcomes after craniotomy for brain tumor resection, and results are reported as national estimates. Univariate and multivariate regression analyses of patient and hospital characteristics were conducted to evaluate if craniotomy for tumor resection at a designated children’s hospital was independently associated with 30-day readmissions, mortality rate, and length of stay.

RESULTS

共有4003名病人颅骨切开术for tumor resection were identified using the Nationwide Readmissions Database, with 1258 of these cases (31.4%) treated at children’s hospitals. Patients treated at children’s hospitals were associated with decreased likelihood of 30-day hospital readmission (OR 0.68, 95% CI 0.48–0.97, p = 0.036) compared to patients treated at nonchildren’s hospitals. There was no significant difference in index mortality between patients treated at children’s hospitals and those treated at nonchildren’s hospitals.

CONCLUSIONS

The authors found that patients undergoing craniotomy for tumor resection at children’s hospitals were associated with decreased rates of 30-day readmission, with no significant difference in index mortality. Future prospective studies may be warranted to confirm this association and identify components contributing to improved outcomes in care at children’s hospitals.

InJournal of Neurosurgery: Pediatrics Volume 32: Issue 3 (Sep 2023)

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Myelomeningocele repair at pediatric hospitals: association with routine discharge and shorter hospital stay

Jane S. Han, Shivani D. Rangwala, Brandon B. Ge, Kristie Q. Liu, Li Ding, William J. Mack, Susan Durham, Mark D. Krieger, and Frank J. Attenello

OBJECTIVE

Postnatal repair for myelomeningocele (MMC) is a time-sensitive and technically challenging procedure. More experienced hospitals may provide improved outcomes for the complexity of care associated with these patients. No prior study has investigated the impact of MMC treatment at pediatric hospitals. The authors sought to examine the effect of pediatric hospital designation on patients undergoing postnatal MMC repair to identify factors associated with maximizing improved patient outcomes.

开云体育世界杯赔率

再入院全国数据库记录2010 to 2018 were analyzed retrospectively to determine the effect of hospital designation on patient outcomes after postnatal MMC repair. Univariate and multivariate regression analyses of patient and hospital characteristics were conducted to evaluate if MMC repair at a designated pediatric hospital was independently associated with patient outcomes of perinatal infection rates, discharge disposition, and length of stay.

RESULTS

Of the total of 6353 pediatric patients who underwent postnatal MMC repair between 2010 and 2018, 2224 (35.0%) received care at a pediatric hospital. Those with an extreme level of disease burden as defined by the all patient refined diagnosis-related group severity of illness index were more likely to be treated at a pediatric hospital (p = 0.03). Patients undergoing repair at a pediatric hospital were also associated with a decreased likelihood of perinatal infection (OR 0.54, 95% CI 0.35–0.83, p = 0.005); greater likelihood of routine disposition (OR 4.85, 95% CI 2.34–10.06, p < 0.0001); and shorter length of stay (incidence rate ratio 0.88, 95% CI 0.77–0.995, p = 0.04).

CONCLUSIONS

Pediatric patients requiring intervention for postnatal repair of MMC may benefit from the multidisciplinary subspeciality care offered at pediatric hospitals. The authors found that postnatal repair of MMC at pediatric hospitals was associated with a greater likelihood of improved patient outcomes.

InJournal of Neurosurgery: Pediatrics Volume 32: Issue 3 (Sep 2023)

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