Re-admissions to hospital within 30 days of hospital discharge with rotavirus gastroenteritis: a UK study on children under 5 years of age
Aims To compare the duration of re-admissions in children <5 based on the diagnosis at their prior admission, and examine the impact of co-morbidities.
Methods UK hospital inpatient data were obtained from the Capse Healthcare Knowledge Systems (CHKS) database from 01/04/2000 to 31/03/2008, for children aged <5 years, with a diagnosis of rotavirus (RVGE) (ICD-10 A08.0) or non-rotavirus gastroenteritis (NRV) (A09*, A08.3-5). The first diagnosis with a seasonal infection, during that admission, was taken as the patient's main infection. Patients were classified as a primary or secondary patient dependent on whether the infection was the primary or secondary (co-morbid) cause of admission. Admission numbers were based on unique admissions, generated from finished consultant episodes. Patients admitted with RVGE or NRV were tracked backwards for 30 days to identify prior hospital admissions with any cause.
Results 167,576 admissions with NRV and 19,227 admissions with RVGE occurred; 21,174 (12.6%) and 4,374 (22.7%) were re-admissions respectively. 47.6% of those with NRV were re-admitted within 5 days, and 74.7% of those with RVGE within 5 days.
Children re-admitted with RVGE were re-admitted to hospital for a mean period of 5.4 days (SD 20.6), and with NRV for 1.7 days (SD 7.5), co-morbidities increased this length of stay (LOS) by 11.0 days (SD 7.1 p<0.001). Children previously admitted with RVGE or NRV had a significantly shorter hospital LOS (p<0.001 – p=0.002) on readmission than patients previously admitted with any other diagnosis. Children admitted with RVGE or NRV had a significantly longer LOS if their prior diagnosis was a neoplasm (p<0.001). Of those re-admitted with RVGE or NRV, 26.9% had previously been admitted with another gastrointestinal condition (ICD-10 chapter 11 code), and 32.4% with an ICD-10 chapter 18 code (all other category).
Conclusion Re-admission occurs more frequently with RVGE than with NRV, while also incurring increased LOS. Children re-admitted with co-morbidities have a more complicated clinical course with RVGE and NRV.
Universal rotavirus vaccination would substantially benefit vulnerable children through direct or indirect protection and reduce the healthcare resource use resulting from hospital readmissions.