Background
Methods
We conducted a retrospective cohort study using the multicenter Pediatric Health Information System (PHIS) database (2010–2022). We included children aged 2–18 years undergoing elective, non-otolaryngologic ambulatory surgery. MM was defined using complex chronic conditions and categorized as no chronic condition, mild–moderate MM (1–2 conditions), or severe MM (≥ 3 conditions). The primary outcome was same-day hospital admission, defined as hospital length of stay ≥ 1 day among children who were scheduled for ambulatory surgery. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sex, age, insurance status, and procedural group.
Results
Among 1 609 584 children who underwent outpatient surgery, 7.6% (n = 126 403) had MM, including 6.9% (n = 111 090) with Mild–moderate MM and 0.7% (n = 15 313) with severe MM. Same-day admission occurred in 4.1% (60 576/1483181) of children without MM, 10.0% (11 131/111090) with mild–moderate MM, and 11.1% (1699/15313) with severe MM. Compared with children without MM, adjusted odds of same-day admission were higher for mild–moderate MM (OR: 1.94; 95% CI: 1.90–1.99) and severe MM (OR: 2.30; 95% CI: 2.18–2.43).
Conclusions
MM is prevalent among pediatric ambulatory surgical patients. Children with MM have higher rates of same-day hospital admission following elective ambulatory surgery compared to their peers, a factor that should be considered in scheduling these patients.
Key Points
What is already known about the topic
Children with multimorbidity are at increased risk of adverse perioperative outcomes. However, the prevalence of multimorbidity and its association with same-day hospital admission following scheduled pediatric ambulatory surgery has not been well described.
What new information this study adds
Children with multimorbidity have higher rates of same-day admission following an elective ambulatory surgery, and the risk increases with an increasing number of chronic medical conditions.