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American Academy of Pediatrics
Research Articles

Development and Validation of a Web-Based Pediatric Readmission Risk Assessment Tool

Thom Taylor, Danielle Altares Sarik and Daria Salyakina
Hospital Pediatrics March 2020, 10 (3) 246-256; DOI: https://doi.org/10.1542/hpeds.2019-0241
Thom Taylor
aNicklaus Children’s Research Institute,
bNicklaus Children’s Health System, Miami, Florida; and
cResearch Facilitation Laboratory, Northrop Grumman, Monterey, California
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Danielle Altares Sarik
bNicklaus Children’s Health System, Miami, Florida; and
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Daria Salyakina
aNicklaus Children’s Research Institute,
bNicklaus Children’s Health System, Miami, Florida; and
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Abstract

OBJECTIVES: Accurately predicting and reducing risk of unplanned readmissions (URs) in pediatric care remains difficult. We sought to develop a set of accurate algorithms to predict URs within 3, 7, and 30 days of discharge from inpatient admission that can be used before the patient is discharged from a current hospital stay.

METHODS: We used the Children’s Hospital Association Pediatric Health Information System to identify a large retrospective cohort of 1 111 323 children with 1 321 376 admissions admitted to inpatient care at least once between January 1, 2016, and December 31, 2017. We used gradient boosting trees (XGBoost) to accommodate complex interactions between these predictors.

RESULTS: In the full cohort, 1.6% of patients had at least 1 UR in 3 days, 2.4% had at least 1 UR in 7 days, and 4.4% had at least 1 UR within 30 days. Prediction model discrimination was strongest for URs within 30 days (area under the curve [AUC] = 0.811; 95% confidence interval [CI]: 0.808–0.814) and was nearly identical for UR risk prediction within 3 days (AUC = 0.771; 95% CI: 0.765–0.777) and 7 days (AUC = 0.778; 95% CI: 0.773–0.782), respectively. Using these prediction models, we developed a publicly available pediatric readmission risk scores prediction tool that can be used before or during discharge planning.

CONCLUSIONS: Risk of pediatric UR can be predicted with information known before the patient’s discharge and that is easily extracted in many electronic medical record systems. This information can be used to predict risk of readmission to support hospital-discharge–planning resources.

  • Copyright © 2020 by the American Academy of Pediatrics
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Hospital Pediatrics: 10 (3)
Hospital Pediatrics
Vol. 10, Issue 3
1 Mar 2020
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Development and Validation of a Web-Based Pediatric Readmission Risk Assessment Tool
Thom Taylor, Danielle Altares Sarik, Daria Salyakina
Hospital Pediatrics Mar 2020, 10 (3) 246-256; DOI: 10.1542/hpeds.2019-0241

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Development and Validation of a Web-Based Pediatric Readmission Risk Assessment Tool
Thom Taylor, Danielle Altares Sarik, Daria Salyakina
Hospital Pediatrics Mar 2020, 10 (3) 246-256; DOI: 10.1542/hpeds.2019-0241
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