Factors influencing unplanned readmissions after paediatric haematopoietic stem cell transplantation and effect on overall survival

Given the increasing attention on unplanned readmissions among paediatric haematopoietic stem cell transplant patients, studies on prevalence and modifiable risk factors are essential for improving transplant outcomes. We analysed the prevalence and risk factors for unplanned readmissions in paediatric patients after haematopoietic stem cell transplantation, the impact of unplanned readmission on overall survival, and how to identify high-risk children and develop intervention strategies. We retrospectively analysed the data and status of unplanned readmissions (within 30 days of discharge) among 548 children who underwent haematopoietic stem cell transplantation at a specialised hospital in Chongqing (June 2013-August 2023). We used logistic regression analysis to identify unplanned readmission risk factors, and Kaplan-Meier survival curves and log-rank tests to analyse survival data. Our findings reveal that 139 children (25.36%) experienced unplanned readmissions and the factors influencing these readmissions include cytomegalovirus serological status before transplantation (OR = 66.324, p < 0.001), conditioning regimen (OR = 2.479, p = 0.036), infection during hospitalisation (OR = 11.914, p = 0.011), and length of hospitalisation (OR = 2.907, p = 0.005). Within the 1-year follow-up, 85 children (15.51%) died. Unplanned readmission significantly reduced survival rates (χ² = 17.37, p < 0.05). Medical staff should manage unplanned readmissions, particularly among patients with the identified risk factors, and use a targeted comprehensive intervention strategy to improve long-term survival.