ArticlePediatrics2019
Pneumonia Prevention Strategies for Children With Neurologic Impairment.
Article in Pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 27 citations in OpenAlex.
- Optimising respiratory health in children with neurodevelopmental impairment.Breathe (Sheffield, England) · 2026Review
- Risk of pneumonia and mortality after routine dental scaling in patients with moderate-to-severe cerebral palsy: A nationwide cohort study.Journal of dental sciences · 2026Article
- 12 years of specialized pediatric palliative inpatient care: description of patients' characteristics.Frontiers in pediatrics · 2026Article
- Recurrent Intensive Care Episodes and Mortality Among Children With Severe Neurologic Impairment.JAMA network open · 2024Article
- Clinical recommendations for the inpatient management of lower respiratory tract infections in children and adolescents with severe neurological impairment in Germany.European journal of pediatrics · 2024Review
- Validation of Neurologic Impairment Diagnosis Codes as Signifying Documented Functional Impairment in Hospitalized Children.Academic pediatrics · 2022Article
- Lower Respiratory Tract Infections in Pediatric Patients with Severe Neurological Impairments: Clinical Observations and Perspectives in a Palliative Care Unit.Children (Basel, Switzerland) · 2022Article
- Evaluation and Management of Respiratory Illness in Children With Cerebral Palsy.Frontiers in pediatrics · 2020Review
- Differences in the Oral Health of Children With Medical Complexity.Academic pediatricsArticle
Corrections and comments
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Authors and funding
10 authors at 10 institutions in 2 countries.
Funding
Abstract
backgroundChildren with neurologic impairment (NI) face high risk of recurrent severe pneumonia, with prevention strategies of unknown effectiveness. We evaluated the comparative effectiveness of secondary prevention strategies for severe pneumonia in children with NI.
methodsWe included children enrolled in California Children's Services between July 1, 2009, and June 30, 2014, with NI and 1 pneumonia hospitalization. We examined associations between subsequent pneumonia hospitalization and expert-recommended prevention strategies: dental care, oral secretion management, gastric acid suppression, gastrostomy tube placement, chest physiotherapy, outpatient antibiotics before index hospitalization, and clinic visit before or after index hospitalization. We used a 1:2 propensity score matched model to adjust for covariates, including sociodemographics, medical complexity, and severity of index hospitalization.
resultsAmong 3632 children with NI and index pneumonia hospitalization, 1362 (37.5%) had subsequent pneumonia hospitalization. Only dental care was associated with decreased risk of subsequent pneumonia hospitalization (adjusted odds ratio [aOR]: 0.64; 95% confidence interval [CI]: 0.49-0.85). Exposures associated with increased risk included gastrostomy tube placement (aOR: 2.15; 95% CI: 1.63-2.85), chest physiotherapy (aOR: 2.03; 95% CI: 1.29-3.20), outpatient antibiotics before hospitalization (aOR: 1.42; 95% CI: 1.06-1.92), clinic visit before (aOR: 1.30; 95% CI: 1.11-1.52), and after index hospitalization (aOR: 1.72; 95% CI: 1.35-2.20).
conclusionsDental care was associated with decreased recurrence of severe pneumonia. Several strategies, including gastrostomy tube placement, were associated with increased recurrence, possibly due to unresolved confounding by indication. Our results support a clinical trial of dental care to prevent severe pneumonia in children with NI.
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