Evidence map›Paper›PMID 40790566›Full record

SynthesisBMC pulmonary medicine2025

Readmission and mortality among children requiring long-term mechanical ventilation via tracheostomy: a systematic review.

Lindsey Scheller, Karley Mariano, Sandra Staveski, Sandra Weiss, Abbey Alkon, Christopher J Russell, Leia Casey, Yoshimi Fukuoka

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Lindsey SchellerSchool of Nursing, University of California San Francisco, 490 Illinois St., San Francisco, CA, 94143, USA. Lindsey.Scheller@ucsf.edu.
Karley MarianoSchool of Nursing, University of California San Francisco, 490 Illinois St., San Francisco, CA, 94143, USA.
Sandra StaveskiSchool of Nursing, University of California San Francisco, 490 Illinois St., San Francisco, CA, 94143, USA.
Sandra WeissSchool of Nursing, University of California San Francisco, 490 Illinois St., San Francisco, CA, 94143, USA.
Abbey AlkonSchool of Nursing, University of California San Francisco, 490 Illinois St., San Francisco, CA, 94143, USA.
Christopher J RussellStanford University, Stanford, CA, USA.
Leia CaseySchool of Nursing, University of California San Francisco, 490 Illinois St., San Francisco, CA, 94143, USA.
Yoshimi FukuokaSchool of Nursing, University of California San Francisco, 490 Illinois St., San Francisco, CA, 94143, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHome environments improve quality of life and reduce infections for children on long-term mechanical ventilation via tracheostomy (LTMV-T). However, unexpected hospital readmissions and death remain significant concerns. Existing systematic reviews have not fully examined risk factors for readmission and mortality. This review examines modifiable and non-modifiable risk factors associated with readmission and mortality in infants, children, and adolescents on LTMV-T.

methodsFive databases (PubMed, CINAHL, Web of Science, Embase, and Epistemonikos) were searched from inception to 2024. All quantitative study designs examining risk factors associated with readmission and/or mortality in children less than 21 years of age on LTMV-T were included. Articles were limited to peer-reviewed journals and the English language. Covidence software was used for data management, study screening, and data extraction. Each abstract was reviewed by two independent reviewers and discrepancies were resolved by a third. The Joanna Briggs Institute critical appraisal tools were used to assess risk of bias in individual studies.

resultsTwenty-six studies examined cohorts of children on LTMV-T from 1980 to 2023. Studies were primarily retrospective cohorts, with sample sizes ranging from 27 to 8,009 children. Most studies reported that at least 50% of readmissions occurred within the first two years post-discharge and respiratory-related issues accounted for 30-75% of readmissions. Mortality within the first-year post-discharge varied as low as 0% to as high as 16%. Few studies examined socioenvironmental risk factors or those specific to LTMV-T populations, conducting analyses primarily on tracheostomy-only and/or LTMV-T cohorts. Risk factors for readmission and mortality included age, lower income, discharge disposition, chronic conditions, lack of respiratory physiotherapy (cough assist, percussions), gastrostomy tube, and lower birth weight. Risk of bias ranged from low to moderate due to unclear outcome measures and analyses that did not address potential confounders.

conclusionsReadmissions are common occurrences among children on LTMV-T with considerable risk of mortality, especially within the first two-years post-discharge. Risk factors identified were predominately clinical and demographic characteristics that can inform risk assessments and targeted interventions. Future studies should further explore socioenvironmental factors such as social determinants of health among LTMV-T specific populations.

trial registrationInternational Prospective Register of Systematic Reviews ID: CRD42024492773.

Indexed as

Patient ReadmissionRespiration, ArtificialTracheostomyAdolescentChildChild, PreschoolHumansInfantRisk FactorsChildrenHospitalizationLong-term mechanical ventilationMortalityReadmissionSystematic reviewTracheostomy

Identifiers

PMID40790566
PMCPMC12341097

What OpenQuestion holds

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Registered trials

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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.