RESUMEN
OBJECTIVES: To describe the characteristics and outcomes of children discharged from the hospital with new nasoenteral tube (NET) use after acute hospitalization. METHODS: Retrospective cohort study using multistate Medicaid data of children <18 years old with a claim for tube feeding supplies within 30 days after discharge from a nonbirth hospitalization between 2016 and 2019. Children with a gastrostomy tube (GT) or requiring home NET use in the 90 days before admission were excluded. Outcomes included patient characteristics and associated diagnoses, 30-day emergency department (ED-only) return visits and readmissions, and subsequent GT placement. RESULTS: We identified 1815 index hospitalizations; 77.8% were patients ≤5 years of age and 81.7% had a complex chronic condition. The most common primary diagnoses associated with index hospitalization were failure to thrive (11%), malnutrition (6.8%), and acute bronchiolitis (5.9%). Thirty-day revisits were common (49%), with 26.4% experiencing an ED-only return and 30.9% hospital readmission. Revisits with a primary diagnosis code for tube displacement/dysfunction (10.7%) or pneumonia/pneumonitis (0.3%) occurred less frequently. A minority (16.9%) of patients progressed to GT placement within 6 months, 22.3% by 1 year. CONCLUSIONS: Children with a variety of acute and chronic conditions are discharged from the hospital with NET feeding. All-cause 30-day revisits are common, though revisits coded for specific tube-related complications occurred less frequently. A majority of patients do not progress to GT within a year. Home NET feeding may be useful for facilitating discharge among patients unable to meet their oral nutrition goals but should be weighed against the high revisit rate.
Asunto(s)
Alta del Paciente , Neumonía , Niño , Humanos , Anciano de 80 o más Años , Adolescente , Estudios Retrospectivos , Readmisión del Paciente , Intubación Gastrointestinal , Gastrostomía , Servicio de Urgencia en HospitalRESUMEN
Among 182 children with influenza infection in 2016-2017, 18% had neurologic manifestations of influenza (NMI), including seizures and encephalopathy; 85% of these children were infected with the H3N2 strain. Children with NMI had 3.5-times-higher odds of having a neurologic comorbidity than those without NMI and a 10-fold increased odds of hospitalization.