{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:00:51Z","timestamp":1790420451292,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic health conditions affect approximately 27% of children in the United States and about 1 in 15 has multimorbidity (MM), defined as the coexistence of two or more chronic conditions. Despite its prevalence, the effect of MM on outcomes after ambulatory surgery remains poorly understood. Hospital admission following a scheduled outpatient procedure is an important measure of perioperative quality and safety. We therefore aimed to estimate the prevalence of MM among children scheduled for elective ambulatory surgery and to evaluate its association with same\u2010day hospital admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the multicenter Pediatric Health Information System (PHIS) database (2010\u20132022). We included children aged 2\u201318\u2009years undergoing elective, non\u2010otolaryngologic ambulatory surgery. MM was defined using complex chronic conditions and categorized as no chronic condition, mild\u2013moderate MM (1\u20132 conditions), or severe MM (\u2265\u20093 conditions). The primary outcome was same\u2010day hospital admission, defined as hospital length of stay \u2265\u20091\u2009day 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1\u2009609\u2009584 children who underwent outpatient surgery, 7.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009126\u2009403) had MM, including 6.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009111\u2009090) with Mild\u2013moderate MM and 0.7% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915\u2009313) with severe MM. Same\u2010day admission occurred in 4.1% (60\u2009576\/1483181) of children without MM, 10.0% (11\u2009131\/111090) with mild\u2013moderate MM, and 11.1% (1699\/15313) with severe MM. Compared with children without MM, adjusted odds of same\u2010day admission were higher for mild\u2013moderate MM (OR: 1.94; 95% CI: 1.90\u20131.99) and severe MM (OR: 2.30; 95% CI: 2.18\u20132.43).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MM is prevalent among pediatric ambulatory surgical patients. Children with MM have higher rates of same\u2010day hospital admission following elective ambulatory surgery compared to their peers, a factor that should be considered in scheduling these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pan.70319","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:16:19Z","timestamp":1790417779000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Multimorbidity in Children Undergoing Ambulatory Surgical Procedures With Same\u2010Day Admissions"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3172-4410","authenticated-orcid":false,"given":"Chhaya","family":"Patel","sequence":"first","affiliation":[{"name":"Children's Healthcare of Atlanta Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mpody","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3543-8867","authenticated-orcid":false,"given":"Emmanuel","family":"Alalade","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9611-0438","authenticated-orcid":false,"given":"Oluwaseun","family":"Akinkuolie","sequence":"additional","affiliation":[{"name":"CUNY School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6876-2667","authenticated-orcid":false,"given":"Sibelle Aurelie Yemele","family":"Kitio","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olubukola O.","family":"Nafiu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"issue":"1","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/13814780802436093","article-title":"Multimorbidity in Primary Care: Prevalence and Trend Over the Last 20\u2009Years","volume":"14","author":"Uijen A. 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P.","year":"2013","journal-title":"International Journal for Equity in Health"},{"issue":"1","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1177\/2150131914540916","article-title":"Effect of Multiple Chronic Diseases on Health Care Expenditures in Childhood","volume":"6","author":"Zhong W.","year":"2015","journal-title":"Journal of Primary Care and Community Health"},{"issue":"7","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1001\/jama.2010.104","article-title":"Dynamics of Obesity and Chronic Health Conditions Among Children and Youth","volume":"303","author":"Van Cleave J.","year":"2010","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2022.07.003"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2018.02.003"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1213\/ANE.0000000000004947","article-title":"Unanticipated Hospital Admission After Ambulatory Surgery: The Devil Is in the Details","volume":"131","author":"Joshi G. 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