ArticleThe Pediatric infectious disease journal2014
Management and outcomes of pneumonia among children with complex chronic conditions.
Article in The Pediatric infectious disease journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Prevalence and healthcare burden of inappropriate antimicrobial treatment in patients at high risk of complications from acute respiratory infections: a scoping review.Frontiers in medicine · 2025Pooled it
- Community-Acquired Pneumonia Diagnosis Following Emergency Department Visits for Respiratory Illness.Clinical pediatrics · 2025Article
- Outpatient Antibiotic Use and Treatment Failure Among Children With Pneumonia.JAMA network open · 2024Article
- Adaptive Intervention to Prevent Respiratory Illness in Cerebral Palsy: Protocol for a Feasibility Pilot Randomized Controlled Trial.JMIR research protocols · 2024Article
- Disease burden and high-risk populations for complications in patients with acute respiratory infections: a scoping review.Frontiers in medicine · 2024Article
- The Role of Mannose-Binding Lectin and Inflammatory Markers in Establishing the Course and Prognosis of Community-Acquired Pneumonia in Children.Children (Basel, Switzerland) · 2023Article
- Antibiotic Use and Respiratory Viral PCR Testing Among Pediatric Patients With Nosocomial Fever.Cureus · 2023Article
- Disease severity of community-acquired pneumonia among children with medical complexity.Pediatric pulmonology · 2023Article
- The impact of the COVID-19 pandemic on children with medical complexity.BMC pediatrics · 2022Article
- Associations between comorbidity-related functional limitations and pneumonia outcomes.Journal of hospital medicine · 2022Article
- Disease Severity and Risk Factors of 30-Day Hospital Readmission in Pediatric Hospitalizations for Pneumonia.Journal of clinical medicine · 2022Article
- Impact of children with complex chronic conditions on costs in a tertiary referral hospital.Revista de saude publica · 2022Article
- Study on the Changes and Significance of Immune State and Cycokines in Children with Adenovirus Pneumonia.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Role of Respiratory Syncytial Virus in Pediatric Pneumonia.Microorganisms · 2020Review
- Discharge Before Return to Respiratory Baseline in Children With Neurologic Impairment.Journal of hospital medicine · 2020Article
- Decreasing trend in the incidence of serious pneumonias in Finnish children with juvenile idiopathic arthritis.Clinical rheumatology · 2020Article
- Parent Perspectives During Hospital Readmissions for Children With Medical Complexity: A Qualitative Study.Hospital pediatrics · 2020Article
- Epidemiology of Children With Multiple Complex Chronic Conditions in a Mixed Urban-Rural US Community.Hospital pediatrics · 2019Article
- Developing Prediction Models for 30-Day Unplanned Readmission Among Children With Medical Complexity.Hospital pediatrics · 2019Article
- Respiratory syncytial virus (RSV) infection in children with medical complexity.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
introductionAlthough pneumonia is a common reason for pediatric hospitalization among children with complex chronic conditions (CCC), treatment and outcomes have not been well-described. We characterized the presentation, management and outcomes of pneumonia in children with and without CCC and described how antibiotic management and outcomes vary among subgroups of children with CCC.
methodsWe conducted a cohort study of children <18 years with pneumonia across a large sample of US hospitals. Children were grouped according to CCC subgroups. Differences in disease management and outcomes were assessed using multivariable regression.
resultsOf the 31,684 children in our cohort, 11.9% had CCC. Children with CCC were more likely to receive intensive investigations and therapies, were less likely to receive aminopenicillins or third generation cephalosporins and were more likely to receive antibiotics against methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and anaerobes. Compared with children without these conditions, children with CCC had significantly increased length of stay [relative risk 1.43, 95% confidence interval (CI) 1.39-1.48] and hospital costs (relative risk 1.38, 95% CI 1.33-1.43), with increased odds of antibiotic escalation (odds ratio 1.51, 95% CI 1.35-1.70), pneumonia complications (odds ratio 1.47, 95% CI 1.24-1.75) and readmission (odds ratio 4.0, 95% CI 3.2-5.0). DISCUSSION: Children with CCC comprise a significant proportion of children hospitalized for pneumonia and are at substantially increased risk of adverse outcomes. They have high rates of treatment with broad spectrum antibiotics, both at the time of hospitalization and subsequently. Research is needed to inform decision-making and guideline development, with goals of reducing adverse outcomes and unnecessary variation in management among children with CCC.
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