Joanna Thomson1, Matt Hall2, Lilliam Ambroggio3, Bryan Stone4, Rajendu Srivastava5, Samir S Shah6, Jay G Berry7. 1. Divisions of Hospital Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; joanna.thomson@cchmc.org. 2. Children's Hospital Association, Overland Park, Kansas; 3. Divisions of Hospital Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Biostatistics and Epidemiology, and. 4. Primary Children's Medical Center, Intermountain Health Care, Salt Lake City, Utah; Division of Inpatient Medicine, Department of Pediatrics, University of Utah, Salt Lake City, Utah; 5. Primary Children's Medical Center, Intermountain Health Care, Salt Lake City, Utah; Division of Inpatient Medicine, Department of Pediatrics, University of Utah, Salt Lake City, Utah; Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, Utah; 6. Divisions of Hospital Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; 7. Division of General Pediatrics, Children's Hospital Boston, Boston, Massachusetts; and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND AND OBJECTIVE: Children with neurologic impairment (NI) are commonly hospitalized for different types of pneumonia, including aspiration pneumonia. We sought to compare hospital management and outcomes of children with NI diagnosed with aspiration versus nonaspiration pneumonia. METHODS: A retrospective study of 27 455 hospitalized children aged 1 to 18 years with NI diagnosed with pneumonia from 2007 to 2012 at 40 children's hospitals in the Pediatric Health Information System database. The primary exposure was pneumonia type, classified as aspiration or nonaspiration. Outcomes were complications (eg, acute respiratory failure) and hospital utilization (eg, length of stay, 30-day readmission). Multivariable regression was used to assess the association between pneumonia type and outcomes, adjusting for NI type, comorbid conditions, and other characteristics. RESULTS: In multivariable analysis, the 9.7% of children diagnosed with aspiration pneumonia experienced more complications than children with nonaspiration pneumonia (34.0% vs 15.2%, adjusted odds ratio [aOR] 1.2 (95% confidence interval [CI] 1.1-1.3). Children with aspiration pneumonia had significantly longer length of stay (median 5 vs 3 days; ratio of means 1.2; 95% CI 1.2-1.3); more ICU transfers (4.3% vs 1.5%; aOR 1.4; 95% CI 1.1-1.9); greater hospitalization costs (median $11 594 vs $5162; ratio of means 1.2; 95% CI 1.2-1.3); and more 30-day readmissions (17.4% vs 6.8%; aOR 1.3; 95% CI 1.2-1.5). CONCLUSIONS: Hospitalized children with NI diagnosed with aspiration pneumonia have more complications and use more hospital resources than when diagnosed with nonaspiration pneumonia. Additional investigation is needed to understand the reasons for these differences.
BACKGROUND AND OBJECTIVE:Children with neurologic impairment (NI) are commonly hospitalized for different types of pneumonia, including aspiration pneumonia. We sought to compare hospital management and outcomes of children with NI diagnosed with aspiration versus nonaspiration pneumonia. METHODS: A retrospective study of 27 455 hospitalized children aged 1 to 18 years with NI diagnosed with pneumonia from 2007 to 2012 at 40 children's hospitals in the Pediatric Health Information System database. The primary exposure was pneumonia type, classified as aspiration or nonaspiration. Outcomes were complications (eg, acute respiratory failure) and hospital utilization (eg, length of stay, 30-day readmission). Multivariable regression was used to assess the association between pneumonia type and outcomes, adjusting for NI type, comorbid conditions, and other characteristics. RESULTS: In multivariable analysis, the 9.7% of children diagnosed with aspiration pneumonia experienced more complications than children with nonaspiration pneumonia (34.0% vs 15.2%, adjusted odds ratio [aOR] 1.2 (95% confidence interval [CI] 1.1-1.3). Children with aspiration pneumonia had significantly longer length of stay (median 5 vs 3 days; ratio of means 1.2; 95% CI 1.2-1.3); more ICU transfers (4.3% vs 1.5%; aOR 1.4; 95% CI 1.1-1.9); greater hospitalization costs (median $11 594 vs $5162; ratio of means 1.2; 95% CI 1.2-1.3); and more 30-day readmissions (17.4% vs 6.8%; aOR 1.3; 95% CI 1.2-1.5). CONCLUSIONS: Hospitalized children with NI diagnosed with aspiration pneumonia have more complications and use more hospital resources than when diagnosed with nonaspiration pneumonia. Additional investigation is needed to understand the reasons for these differences.
Authors: Daniel R Duncan; Paul D Mitchell; Kara Larson; Maireade E McSweeney; Rachel L Rosen Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-12-01 Impact factor: 6.223
Authors: Florentine V Schepers; Karen van Hulst; Bea Spek; Corrie E Erasmus; Lenie van den Engel-Hoek Journal: Dev Med Child Neurol Date: 2021-08-21 Impact factor: 4.864
Authors: Catherine Diskin; Kristina Malik; Peter J Gill; Nada Rashid; Carol Y Chan; Katherine E Nelson; Joanna Thomson; Jay Berry; Rishi Agrawal; Julia Orkin; Eyal Cohen Journal: Dev Med Child Neurol Date: 2021-08-30 Impact factor: 4.864
Authors: Joanna Thomson; Matt Hall; Jay G Berry; Bryan Stone; Lilliam Ambroggio; Rajendu Srivastava; Samir S Shah Journal: J Pediatr Date: 2016-08-22 Impact factor: 4.406
Authors: Joanna Thomson; Matt Hall; Lilliam Ambroggio; Jay G Berry; Bryan Stone; Rajendu Srivastava; Samir S Shah Journal: J Hosp Med Date: 2019-11-20 Impact factor: 2.960
Authors: Joanna Thomson; Matt Hall; Katherine Nelson; Juan Carlos Flores; Brigid Garrity; Danielle D DeCourcey; Rishi Agrawal; Denise M Goodman; James A Feinstein; Ryan J Coller; Eyal Cohen; Dennis Z Kuo; James W Antoon; Amy J Houtrow; Lucia Bastianelli; Jay G Berry Journal: Pediatrics Date: 2021-01-07 Impact factor: 7.124
Authors: Claire Duvallet; Kara Larson; Scott Snapper; Sonia Iosim; Ann Lee; Katherine Freer; Kara May; Eric Alm; Rachel Rosen Journal: PLoS One Date: 2019-05-20 Impact factor: 3.240
Authors: Jessica L Markham; Matt Hall; Jennifer L Goldman; Jessica L Bettenhausen; James C Gay; James Feinstein; Julia Simmons; Stephanie K Doupnik; Jay G Berry Journal: J Hosp Med Date: 2021-03 Impact factor: 2.960