Clinical correlates of 30-day unplanned healthcare reutilization after hospitalization for paediatric Mycoplasma pneumoniae pneumonia: a single-centre retrospective cohort study

Background Children hospitalized with Mycoplasma pneumoniae pneumonia (MPP) may require unplanned healthcare encounters after discharge. This study evaluated the occurrence and clinical correlates of documented 30-day unplanned healthcare reutilization following hospitalization for paediatric MPP. Methods This single-centre retrospective cohort study included 312 children hospitalized with clinically, radiographically, and microbiologically supported MPP between January 2020 and December 2025. The primary outcome was all-cause unplanned healthcare reutilization within 30 days after discharge, including unscheduled outpatient, emergency department, emergency observation, and inpatient encounters recorded in the institutional electronic medical record system. Pneumonia-related reutilization was assessed as a sensitivity outcome, and unplanned readmission was examined exploratorily. Multivariable logistic regression evaluated associations with prespecified clinical characteristics. Results Forty-two of 312 children (13.5%) had documented 30-day unplanned healthcare reutilization. Of these, 34 (81.0%) had pneumonia-related encounters, and 19 children required unplanned readmission. In the primary multivariable model, longer fever duration before admission (adjusted OR per 1-day increase, 1.17; 95% CI, 1.05–1.31), higher early-admission lactate dehydrogenase levels (adjusted OR per 100 U/L increase, 1.27; 95% CI, 1.05–1.54), and being afebrile for less than 48 h before discharge (adjusted OR, 2.18; 95% CI, 1.09–4.36) were associated with higher odds of reutilization. The association with pleural effusion was less certain (adjusted OR, 2.11; 95% CI, 0.99–4.51). Associations were broadly consistent in the pneumonia-related sensitivity analysis, whereas readmission findings were exploratory because only 19 events occurred. Conclusions Documented 30-day unplanned healthcare reutilization was associated with selected admission- and discharge-phase clinical characteristics in children hospitalized with MPP. These observational findings require prospective multicentre validation before clinical application.