Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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While medical complexity is associated with pediatric readmission risk, less is known about how increases in medical complexity during hospitalization affect readmission risk. ⋯ Polypharmacy and use of technology at discharge pose a substantial readmission risk for children. However, added technology and new complex chronic conditions do not increase risk when accounting for length of stay.
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Although neonatal herpes simplex virus (HSV) causes significant morbidity, utilization of the cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR) test remains variable. Our objective was to examine the association of CSF HSV PCR testing with length of stay (LOS) in a 20-center retrospective cohort of hospitalized infants aged ≤60 days undergoing evaluation for meningitis after adjustment for patient-level factors and clustering by center. ⋯ Infants who had a CSF HSV PCR test performed had a 23% longer hospital LOS (incident rate ratio 1.23; 95% CI: 1.14-1.33). Targeted CSF HSV PCR testing may mitigate the impact on LOS for low-risk infants.
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American Society of Hematology 2018 Guidelines for the management of venous thromboembolism: treatment of pediatric venous thromboembolism DEVELOPER: The American Society of Hematology multidisciplinary subcommittee RELEASE DATE: November 27, 2018 FUNDING SOURCE: American Society of Hematology PRIOR VERSION: N/A TARGET POPULATION: less than 18 years of age.
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Though often undertaken to provide patients with specialized care, interhospital transfer (IHT) is associated with worse outcomes for select patients. Certain aspects of the transfer process have been suggested as contributors to these outcomes. We performed a retrospective cohort study including patients ≥ 18 years who underwent IHT to a tertiary care hospital between January 2005 and September 2013. ⋯ Stratified analyses demonstrated a significant association between transfer characteristics and adjusted odds of 30-day mortality among cardiothoracic and gastrointestinal surgical service transfers. Our findings suggest high acuity patients have worse outcomes during off-peak times of transfer and during times of high care team workload. Further study is needed to identify underlying reasons to explain these associations and devise potential solutions.