{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:22:23Z","timestamp":1773274943200,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric oncology patients have high rates of hospital readmission but there is a dearth of research into risk factors for unplanned 30\u2010day readmissions among this high\u2010risk population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>In this study, we built a statistical model to provide insight into risk factors of unplanned readmissions in this pediatric oncology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrieved 32\u2009667 encounters from 10\u00a0418 pediatric patients with a neoplastic condition from 16 hospitals in the Cerner Health Facts Database and built a mixed\u2010effects model with patients nested within hospitals for inference on 75% of the data and reserved the remaining as an independent test dataset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mixed\u2010effects model indicated that patients with acute lymphoid leukemia (in relapse), neuroblastoma, rhabdomyosarcoma, or bone\/cartilage cancer have increased odds of readmission. The number of cancer medications taken by the patient and the administration of chemotherapy were associated with increased odds of readmission for all cancer types. Wilms Tumor had a significant interaction with administration of chemotherapy, indicating that the risk due to chemotherapy is exacerbated in patients with Wilms Tumor. A second two\u2010way interaction between recent history of chemotherapy treatment and infections was associated with increased odds of readmission. The area under the receiver operator characteristic curve (and corresponding 95% confidence interval) of the mixed\u2010effects model was 0.714 (0.702, 0.725) on the independent test dataset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Readmission risk in oncology is modified by the specific type of cancer, current and past administration of chemotherapy, and increased health care utilization. Oncology\u2010specific models can provide decision support where model built on other or mixed population has failed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1343","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T09:06:08Z","timestamp":1612602368000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Multicenter study of risk factors of unplanned 30\u2010day readmissions in pediatric oncology"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5089-2308","authenticated-orcid":false,"given":"Kamila","family":"Hoenk","sequence":"first","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"},{"name":"Beckman Research Institute City of Hope  Duarte California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilibeth","family":"Torno","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Feaster","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharief","family":"Taraman","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Chang","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Weiss","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Pugh","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittney","family":"Anderson","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1369-7954","authenticated-orcid":false,"given":"Louis","family":"Ehwerhemuepha","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County  Orange California USA"},{"name":"Schmid College of Science and Technology Chapman University  Orange California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21219"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30761-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.56.7743"},{"issue":"8","key":"e_1_2_10_6_1","first-page":"IV\u20103","article-title":"Overview of the SEER\u2010Medicare data: content, research applications, and generalizability to the United States elderly population","volume":"40","author":"Warren JL","year":"2002","journal-title":"Med Care"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2019-0122"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2017-0220"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-1720"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.18.00500"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1515"},{"issue":"1","key":"e_1_2_10_12_1","first-page":"1","article-title":"HealtheDataLab \u2010 A cloud computing solution for data science and advanced analytics in healthcare with application to predicting multi\u2010center pediatric readmissions","volume":"20","author":"Ehwerhemuepha L","year":"2020","journal-title":"BMC Med. 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