Evidence map›Paper›PMID 39725740›Full record

ArticlePediatric cardiology2025

Neighborhood Income Disparities in Unplanned Hospital Admission and In-Hospital Outcomes Among Children with Congenital Heart Disease.

Laxmi V Ghimire, Sagya Khanal, Zareh Torabyan, Hiba El-Rahi, Catherine Cong, Fu-Sheng Chou, Othman A Aljohani, Anita J Moon-Grady

Abstract read
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In one paragraph

Article in Pediatric cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Laxmi V GhimireDivision of Pediatric Cardiology, Department of Pediatrics, University of California, San Francisco, Fresno Regional Campus, 215 N Fresno St, Fresno, CA, USA. Laxmi.Ghimire@ucsf.edu.
Sagya KhanalNepal Medical College, Kathmandu, Nepal.
Zareh TorabyanDepartment of Pediatrics, University of California, San Francisco, Fresno Campus, Fresno, CA, USA.
Hiba El-RahiDepartment of Pediatrics, University of California, San Francisco, Fresno Campus, Fresno, CA, USA.
Catherine CongDepartment of Pediatrics, University of California, San Francisco, Fresno Campus, Fresno, CA, USA.
Fu-Sheng ChouDepartment of Neonatal-Perinatal Medicine, Kaiser Permanente Riverside Medical Center, Riverside, CA, USA.
Othman A AljohaniDivision of Pediatric Cardiology, Benioff Children's Hospital, Department of Pediatrics, University of California, San Francisco (UCSF), San Francisco, CA, USA.
Anita J Moon-GradyDivision of Pediatric Cardiology, Benioff Children's Hospital, Department of Pediatrics, University of California, San Francisco (UCSF), San Francisco, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Unplanned admissions are associated with worse clinical outcomes and increased hospital resource utilization. We hypothesized that children with congenital heart disease (CHD) from lower-income neighborhoods have higher rates of unplanned hospital admissions and greater resource utilization. Utilizing the Kids' Inpatient Database (2016 and 2019), we included children under 21 years of age with CHD, excluding newborn hospitalizations. CHD cases were categorized into simple lesions, complex biventricular lesions, and single ventricle lesions. Admissions were classified as surgical or non-surgical. A logistic regression model assessed the risk of unplanned hospital admission, mortality, and resource utilization across different neighborhood income levels. Out of 4,722,684 admitted children (excluding newborn hospitalizations), 199,757 had CHD and met the study criteria: 121,626 with mild CHD, 61,639 with complex biventricular lesions, and 16,462 with single ventricle lesions. Surgical admissions comprised 20% (n = 39,694). In the CHD cohort, 27% had planned admissions, while 73% were unplanned. Mortality was higher in unplanned admissions compared to planned admissions (3.0 vs. 0.93%, P < 0.001). Unplanned admissions were more common in the lowest-income neighborhoods compared to the highest-income neighborhoods (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.3-1.5; P < 0.001), consistent across different age groups. Higher rates of unplanned admissions in the lowest-income neighborhoods were observed for each CHD category and for both medical and surgical admissions. Median hospitalization length was longer in the poorest neighborhoods compared to the wealthiest (7 days [IQR 3-21] vs. 6 days [IQR 3-17], P < 0.001). In conclusion, children with CHD residing in the lowest-income neighborhoods have increased odds of unplanned hospitalization for both surgical and non-surgical admissions, along with higher mortality and resource utilization.

Indexed as

Heart Defects, CongenitalHospitalizationIncomeNeighborhood CharacteristicsAdolescentChildChild, PreschoolFemaleHospital MortalityHumansInfantInfant, NewbornMalePovertyResidence CharacteristicsRetrospective StudiesCongenital heart diseaseElective admissionICD-10 codesSocioeconomic disparityUnited StatesUnplanned admission

Identifiers

PMID39725740
PMCPMC12496258

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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.