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January 9, 2026Journal of the American Academy of Orthopaedic Surgeons

Identifying Risk Factors for Emergency Department Return and Readmission After Pediatric Orthopaedic Surgery: A Retrospective Cohort Study

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Key result

Medicaid insurance status and specific surgical procedures, like infection and spine deformity surgeries, significantly increased odds of postoperative RTED and readmissions.

Authors

DSDevika A. ShenoyCZChristian F. ZirbesATAaron D. Therien

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Overview

This retrospective cohort study identifies risk factors for emergency department returns and readmissions in pediatric surgical patients, suggesting targeted support is needed.

Key Points

  • The aim is to determine risk factors associated with unplanned emergency department returns and readmissions after pediatric orthopaedic surgeries.
  • Conducted a retrospective cohort study from 2017 to 2023.
  • Included patients under 18 who had orthopaedic surgery at a large academic institution.
  • Data collected included demographics, body mass index, insurance, language, and case complexity.
  • Primary outcomes were RTED and readmission within 7, 30, and 90 days post-surgery.
  • Utilized univariable and multivariable logistic regression analyses to find predictors.
  • 3,044 pediatric patients were analyzed.
  • Medicaid insurance increased the odds of 30-day RTED (OR 2.26) and 90-day RTED (OR 2.39), along with 90-day readmission (OR 3.82).
  • Hispanic patients had higher odds of 90-day RTED (OR 1.54).
  • Black or African American patients had significantly higher odds for readmission at 7 days (OR 9.24) and 30 days (OR 4.00).
  • Infection surgery (OR 15.3) and spine deformity surgery (OR 12.0) were linked to increased RTED and readmission.

Cite This Study

Shenoy et al. (2025) studied this question. Medicaid insurance status and specific surgical procedures, like infection and spine deformity surgeries, significantly increased odds of postoperative RTED and readmissions.

synapsesocial.com/papers/69609567f6dae357db7c14eahttps://doi.org/10.5435/jaaos-d-25-00960
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Unplanned Pediatric Surgical Readmissions: Insights from a 3-year Study at a Tertiary Care Center2026
  2. 2Benchmarking Early Unplanned Trauma Re-operations: A Five-Year Institutional Review of 7,400 Orthopaedic Cases2026
  3. 3Early Emergency Department Visits are a Predictor of Increased Health Care Utilization Within 1 Year After Elective Spine Surgery for Degenerative Pathologies2025
  4. 4Adverse Outcomes in Pediatric Orthopaedic Surgery: Insights From the NSQIP Pediatric Database2025
  5. 5Ratio of Postdischarge Emergency Department Visits to Readmissions by Diagnosis2026