{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:59:39Z","timestamp":1790391579643,"version":"4.1.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,17]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Thirty-day unplanned readmission is a key quality metric in pediatric neurosurgery, yet contemporary drivers of readmission in pediatric neurosurgery and whether outcomes are improving remain unknown. Thus, the authors assessed temporal readmission trends and evaluated patient- and hospital-level predictors of 30-day unplanned readmissions across major pediatric neurosurgical procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program Pediatric data (2012\u20132023). Children who underwent CSF shunt placement or revision, craniosynostosis repair, tumor surgery, Chiari decompression, spine procedures, or myelomeningocele closure were included. The primary outcome was 30-day unplanned readmission; secondary endpoints were unplanned reoperation, length of hospital stay (LOS), and mortality. Multivariable logistic regression was used to identify independent predictors, including era of treatment (2012\u20132017 vs 2018\u20132023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 95,104 procedures, readmissions decreased from 10.8% in 2012\u20132017 to 9.1% in 2018\u20132023 (p &lt; 0.001), and the later era independently lowered the readmission risk (adjusted OR [aOR] 0.80, 95% CI 0.76\u20130.84). Unplanned reoperations decreased (from 10.4% to 9.6%, respectively, p &lt; 0.001), LOSs shortened (from 6.89 to 5.92 days, respectively, p &lt; 0.001), and mortality was unchanged (0.5%). Relative to those for shunt placement, readmission odds were higher after shunt revision or removal (aOR 1.28, 95% CI 1.19\u20131.37) and lower after craniosynostosis repair (aOR 0.26, 95% CI 0.22\u20130.30), Chiari decompression (aOR 0.62, 95% CI 0.56\u20130.69), and spine procedures (aOR 0.51, 95% CI 0.46\u20130.56). The readmission risk increased with a higher American Association of Anesthesiologists class (1 vs 3: aOR 1.77, 95% CI 1.48\u20132.12; 1 vs \u2265 4: aOR 1.76, 95% CI 1.44\u20132.15), nonelective case status (emergency: aOR 1.36, 95% CI 1.27\u20131.45), and longer anesthesia time (aOR 1.08, 95% CI 1.06\u20131.09). Early postoperative complications were the strongest correlates for readmission risk: organ\/space surgical site infection (SSI; aOR 19.01, 95% CI 16.77\u201321.55) and superficial SSI (aOR 8.68, 95% CI 7.69\u20139.80).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Pediatric neurosurgical readmissions have improved over the past decade, but risk remains concentrated after shunt revision or removal and among nonelective, high complexity cases, highlighting targets for quality improvement and perioperative efficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.peds25600","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:35Z","timestamp":1784073635000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Patient risk factors for 30-day unplanned readmission after pediatric neurosurgery: are we improving?"],"prefix":"10.3171","author":[{"given":"Sina","family":"Sadeghzadeh","sequence":"first","affiliation":[{"name":"Stanford School of Medicine, Stanford, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaila D.","family":"Ghanekar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Serrato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan D. L.","family":"Brown","sequence":"additional","affiliation":[{"name":"Northwell, New Hyde Park; and"},{"name":"Department of Neurosurgery, North Shore University Hospital, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apratim","family":"Maity","sequence":"additional","affiliation":[{"name":"Northwell, New Hyde Park; and"},{"name":"Department of Neurosurgery, North Shore University Hospital, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"DiLuna","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aladine A.","family":"Elsamadicy","sequence":"additional","affiliation":[{"name":"Northwell, New Hyde Park; and"},{"name":"Department of Neurosurgery, North Shore University Hospital, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"12","key":"b1","series-title":"J Hosp Med","first-page":"723","article-title":"Performance of pediatric readmission measures","volume":"15","author":"Auger KA","year":"2020","unstructured":"Auger KA, Ponti-Zins MC, Statile AM, Wesselkamper K, Haberman B, Hanke SP. Performance of pediatric readmission measures. J Hosp Med. 2020;15(12):723\u2013726. doi:10.12788\/jhm.3521"},{"issue":"4","key":"b2","series-title":"JAMA","first-page":"372","article-title":"Pediatric readmission prevalence and variability across hospitals","volume":"309","author":"Berry JG","year":"2013","unstructured":"Berry JG, Toomey SL, Zaslavsky AM,  Pediatric readmission prevalence and variability across hospitals. JAMA. 2013;309(4):372\u2013380. doi:10.1001\/jama.2012.188351"},{"issue":"14","key":"b3","series-title":"N Engl J Med","first-page":"1418","article-title":"Rehospitalizations among patients in the Medicare fee-for-service program","volume":"360","author":"Jencks SF","year":"2009","unstructured":"Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418\u20131428. doi:10.1056\/NEJMsa0803563"},{"key":"b4","series-title":"Front Surg","first-page":"1199659","article-title":"The impact of unplanned 30-day readmission as a quality indicator in pediatric surgery","volume":"10","author":"Ellul S","year":"2023","unstructured":"Ellul S, Shoukry M. The impact of unplanned 30-day readmission as a quality indicator in pediatric surgery. Front Surg. 2023;10:1199659. doi:10.3389\/fsurg.2023.1199659"},{"key":"b5","series-title":"J Pediatr","first-page":"240","article-title":"Timing and causes of common pediatric readmissions","volume":"200","author":"Bucholz EM","year":"2018","unstructured":"Bucholz EM, Gay JC, Hall M, Harris M, Berry JG. Timing and causes of common pediatric readmissions. 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