Hospital pediatrics
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Hospital pediatrics · May 2019
Timing of Palliative Consultation for Children During a Fatal Illness.
The American Academy of Pediatrics recommends palliative care for children at the diagnosis of serious illness. Yet few children who die receive specialty palliative care consultation, and when it is provided, palliative care consultation tends to occur after >75% of the time from diagnosis until death. Focusing on the timing of palliative consultation in relation to the date of diagnosis, we evaluated factors predicting earlier receipt of pediatric palliative care in a cohort of decedents. ⋯ In a cohort of decedents at our institution, palliative consultation occurred much earlier than has been previously reported. We also identify factors associated with delayed receipt of palliative care among children who are dying that reveal further opportunities to improve access to specialty palliative care.
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Hospital pediatrics · Apr 2019
Multicenter StudyReadmissions to the ICU Among Children With Tracheostomies Placed After Cardiac Arrest.
Describe clinical outcomes and risk factors for ICU readmissions in a cohort of children who underwent tracheostomy placement after cardiac arrest. ⋯ ICU readmission among children who undergo postarrest tracheostomy is common, usually due to respiratory causes, and involves outcomes and resource use similar to other ICU admissions. Risk factors for readmission are largely nonmodifiable.
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Hospital pediatrics · Apr 2019
The Importance of Screening Preteens for Suicide Risk in the Emergency Department.
To describe the prevalence of screening positive for suicide risk in a sample of 10- to 12-year-olds presenting to the emergency department (ED). ⋯ Preteens think about suicide and engage in suicidal behavior at rates that warrant further study. Notably, 7% of preteens presenting with chief medical complaints screened positive, highlighting the importance of screening all preteen patients as young as 10 years old for suicide risk in the ED.
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Hospital pediatrics · Apr 2019
Epidemiology of Readmissions After Sepsis Hospitalization in Children.
The decline in hospital mortality in children hospitalized with sepsis has increased the number of survivors. These survivors are at risk for adverse long-term outcomes, including readmission and recurrent or unresolved infections. We described the epidemiology of 90-day readmissions after sepsis hospitalization in children. We tested the hypothesis that a sepsis hospitalization increases odds of 90-day readmissions. ⋯ Readmissions occur after 1 in 5 pediatric sepsis hospitalizations and increase health care costs. Sepsis hospitalization increased odds of readmission and commonly involved recurrent infection or sepsis. Clinicians caring for these patients should consider surveillance for recurrent or unresolved infection, and researchers should explore underlying mechanisms and potential interventions to reduce readmissions.
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Hospital pediatrics · Apr 2019
Observational StudyPediatric Readmissions Within 3 Days of Discharge: Preventability, Contributing Factors, and Necessity.
Among pediatric 30-day readmissions, 20% to 30% are preventable, and ∼25% are within 3 days of discharge. We investigated the preventability, contributing factors, and necessity of 3-day pediatric readmissions. ⋯ More than one-half of 3-day readmissions were considered either preventable or unnecessary. Clinical decision-making, discharge processes, and improving consensus among families and providers may be valuable areas for future efforts to reduce readmission.