Respiratory Readmissions in First 3 Years of Life for Children with Bronchopulmonary Dysplasia

OBJECTIVE:To examine the demographic, clinical, and environmental characteristics of children with bronchopulmonary dysplasia (BPD) associated with respiratory readmissions. STUDY DESIGN:Demographic and clinical data were obtained from children with BPD recruited from 15 centers participating in the BPD Collaborative between 2018 and 2025. Subjects with any hospital readmission for respiratory reasons were compared with children not readmitted as assessed by questionnaires obtained at clinic visits during the first 3 years of life. Clustered regression models were used to identify variables associated with readmission. Secondary analyses were performed to identify factors associated with a higher number (≥2) of readmissions. RESULTS:There were 1615 participants who met inclusion criteria with a mean age of 9.4 ± 7.5 months at recruitment. During the study period, 352 (21.8%) had at least 1 readmission and 1263 had no reported readmission. In multivariable models, an increased likelihood of readmission was associated with a shorter initial neonatal intensive care unit hospitalization, use of a home ventilator, prescription of reflux medications, daycare attendance, and lower BPD control score. CONCLUSIONS:In young children with BPD, markers of medical complexity, such as home ventilator use for chronic respiratory failure and gastroesophageal reflux, were associated with a high likelihood of respiratory readmissions. Other potentially modifiable factors associated with readmissions include daycare attendance and respiratory symptom control. BPD severity was not associated with readmission risk. Identifying risk factors for respiratory readmission in the outpatient setting will help healthcare providers to provide targeted anticipatory guidance.