Evidence map›Paper›PMID 31153586›Full record

ArticleThe Journal of pediatrics2019

Attributable Delay of Discharge for Children with Long-Term Mechanical Ventilation.

Sarah A Sobotka, Carolyn Foster, Emma Lynch, Lindsey Hird-McCorry, Denise M Goodman

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Observational
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Sarah A SobotkaSection of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, Chicago, IL. Electronic address: ssobotka@peds.bsd.uchicago.edu.
Carolyn FosterDivision of Academic General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL; Mary Ann and J. Milburn Smith Child Health Research, Outreach, Advocacy Center, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Emma LynchSection of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, Chicago, IL.
Lindsey Hird-McCorryPulmonary Habilitation Program/Transitional Care Unit, Ann and Robert H. Lurie Children's Hospital of Chicago.
Denise M GoodmanDivision of Pediatric Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.

Funding

Predictors of Days at Home for Children with Mechanical Ventilator AssistanceK23HD097276 · NICHD · UNIVERSITY OF CHICAGO · PI SOBOTKA, SARAH ANN · 2019 to 2021
$474k
AHRQ HHS K12 HS023007NICHD NIH HHS K23 HD097276
6 · The paper itself

Abstract

objectiveTo assess the reasons for discharge delays for children with long-term mechanical ventilation. STUDY

designCharts of children (0-18 years of age) with a new tracheostomy in the Pulmonary Habilitation Program at the Ann and Robert H. Lurie Children's Hospital of Chicago were retrospectively reviewed for demographic information, medical diagnoses, medical stability, discharge to home, reasons for discharge delay, and hours of staffed home nursing. All patients were discharged on mechanical ventilation. Discharge delay was defined as >10 days after medical stability. Hospital charges were analyzed and excess charges quantified beginning with the date of delay. Descriptive statistics and Pearson χ

resultsOf 72 patients, 55% were male with mean age 1.8 years (SD 3.8) at tracheostomy placement. The most common long-term mechanical ventilation indication was chronic lung disease (n = 47, 65%); 54% had discharge delays, the majority were primarily due to lack of home nursing (62%), followed by delay of caregiver training (18%), caregiver health and social issues (8%), and delay in a transitional care facility bed (8%). Of the 39 delayed patients, 10% ($13 217 889) of hospital charges occurred during excess days with a median of $186 061 (IQR $117 661-$386 905) per patient.

conclusionsOver one-half of children discharged to the community from a large inpatient pediatric long-term mechanical ventilation program had a nonmedical delay of discharge home, most commonly because of home nurse staffing. This case series provides further evidence that limited availability of home nursing impedes efficient discharge and prolongs hospitalizations.

Indexed as

Patient DischargeAdolescentChildChild, PreschoolFemaleHumansInfantLength of StayMaleRespiration, ArtificialRetrospective StudiesTime Factorschildren with long-term mechanical ventilationhome healthcarehospital discharge

Identifiers

PMID31153586
PMCPMC7290238

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.