¿Es necesario un score predictivo de reingreso para el paciente crónico complejo?

IF 2.6 4区医学 Q2 PEDIATRICS

Anales de pediatria Pub Date : 2026-06-01 Epub Date: 2026-05-09 DOI:10.1016/j.anpedi.2026.504247

Jimena Pérez-Moreno, Emiliana Armas Castillo, Juan José Escalonilla García, Blanca Toledo del Castillo, Felipe González Martínez, María Isabel González Sánchez, Rosa Rodríguez-Fernández

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引用次数: 0

Abstract

Introduction

the HOSPITAL score is a tool that assesses the risk of readmission, but it considers oncological disease as the sole chronic condition category linked to readmission risk. In pediatrics, there is no score that includes children with medical complexity (CMC).

Objective

The objective of this study was to analyze the clinical characteristics of all non-oncological pediatric readmissions and to describe risk factors for readmission of CMC.

Methods

We conducted a retrospective and analytical study of readmissions to the pediatric wards of a tertiary hospital (January 2021-June 2023). Readmission was defined as occurring within 30 days of discharge. We compared variables from the HOSPITAL score and the PedCom score in patients with chronic and acute conditions.

Results

the analysis included 241 readmissions; 41.5% were CMC readmissions. Readmitted CMCs were older, predominantly male (76%), and were readmitted more frequently due to worsening of their underlying disease and for the same reason as the first admission (26% vs 7.1%; P < .01) compared to acute patients. Both the HOSPITAL (5 [3-7] vs 2 [1-4]; P < .01) and PedCom (9 [5-14] vs 1 [0-2]; P < .01) scores were higher in the readmitted CMC group. Children with complex chronic disease that have higher PedCom scores are at increased risk of potentially preventable readmission.

Conclusions

Hospital readmissions of CMC patients have different characteristics that must be taken into account for the implementation of preventive measures to avoid readmission.

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复杂的慢性患者是否需要预测复发分数？

医院评分是一种评估再入院风险的工具，但它认为肿瘤疾病是与再入院风险相关的唯一慢性疾病类别。在儿科，没有评分包括儿童的医疗复杂性（CMC）。目的分析所有非肿瘤性儿童再入院的临床特点，并描述CMC再入院的危险因素。方法对某三级医院儿科病房2021年1月- 2023年6月再入院患者进行回顾性分析研究。再入院定义为出院后30天内发生。我们比较了慢性和急性患者的HOSPITAL评分和PedCom评分的变量。结果共纳入241例再入院患者；41.5%为CMC再入院。再次入院的cmc患者年龄较大，主要是男性（76%），与急性患者相比，由于潜在疾病恶化和首次入院原因相同（26% vs 7.1%; P < 0.01）而再次入院的频率更高。再入院CMC组的HOSPITAL评分（5 [3-7]vs 2 [1-4]; P < 0.01）和PedCom评分（9 [5-14]vs 1 [0-2]; P < 0.01）均较高。患有复杂慢性疾病的儿童PedCom评分较高，潜在可预防的再入院风险增加。结论CMC患者的再入院特点各不相同，应结合实际采取预防措施，避免再入院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anales de pediatria 医学-小儿科

CiteScore

2.10

自引率

4.80%

发文量

155

审稿时长

44 days

期刊介绍： La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.