Evidence map›Paper›PMID 41001938›Full record

ArticlePediatric pulmonology2025

Child Opportunity Index and Outcomes of Children Admitted to US PICUs for Critical Asthma.

Michael C McCrory, Amit K Saha, Colin M Rogerson, Jocelyn R Grunwell, Curtis E Kennedy, Meredith C Winter, Martin K Wakeham, Adrian D Zurca, Adam C Dziorny, Aline B Maddux and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric pulmonology, 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. Observational
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

17 authors.

Michael C McCroryDepartments of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.ORCID 0000-0001-5880-750X
Amit K SahaDepartments of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Colin M RogersonDepartments of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0001-5251-2399
Jocelyn R GrunwellDepartments of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Curtis E KennedyDepartments of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Meredith C WinterDepartments of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Martin K WakehamDepartments of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Adrian D ZurcaDepartments of Pediatrics, Northwestern University Feinberg School of Medicine, and Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Adam C DziornyDepartments of Pediatrics, University of Rochester School of Medicine, Rochester, New York, USA.
Aline B MadduxDepartments of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA.ORCID 0000-0002-0949-4284
Mary E HartmanDepartments of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
Neethi P PintoDepartments of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Jia Xin HuangDepartments of Pediatrics, University of California San Francisco, UCSF Benioff Children's Hospital Oakland, Oakland, California, USA.ORCID 0000-0003-4394-6763
Meesha SharmaDepartments of Pediatrics, University of California San Francisco, UCSF Benioff Children's Hospital Oakland, Oakland, California, USA.
Kyle A BarnackDepartments of Anesthesiology and Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
Anjali GargDepartments of Anesthesiology and Critical Care Medicine, Johns Hopkins Charlotte Bloomberg Children's Center, Baltimore, Maryland, USA.
Manzilat Y AkandeDepartments of Pediatrics, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma, USA.

Funding

Research Training in Pediatric Critical Care MedicineT32HD049303 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JEFFREY R FINEMAN · 2006 to 2026
$3.1M
NICHD NIH HHS T32 HD049303The authors received no specific funding for this work.
6 · The paper itself

Abstract

backgroundSocial drivers of health affect severity of asthma in children, but any association with outcomes in children with critical asthma is unknown.

methodsRetrospective cohort study of children 2-17 years old admitted to 15 United States PICUs for asthma from 2019 to 2020. Child Opportunity Index (COI) was assigned by census tract. Primary outcome was use of positive pressure ventilation (PPV), including invasive mechanical ventilation or non-invasive continuous or bilevel support.

resultsA total of 2093 admissions in 1926 patients were included; median age was 6.9 years (IQR 4.3-10.8). Patients were often from very low COI neighborhoods (46.7%), a higher percentage than in children admitted to participating PICUs concurrently for other respiratory (28.2% very low COI) or non-respiratory causes (24.8%) (p < 0.0001 for each comparison). PICU mortality was low (0.57%), with no difference by COI category. Median PICU length of stay was within 8.5 h across COI categories (1.0-1.4 days). PPV was used in 39% of admissions. Multivariable analysis revealed no association of COI category with use of PPV; older age, commercial insurance, and origin of admission were associated with PPV use. PICU readmission for asthma during a subsequent hospitalization occurred in 7.1% patients during the study period, with a stepwise decrease as COI category increased [very low 8.9%; low 7.4%; moderate 5.0%; high 4.4%; very high 3.8%, p = 0.02].

conclusionsChildren admitted to 15 PICUs for asthma were disproportionately from very low COI neighborhoods. Mortality and use of PPV were not significantly associated with COI; however, PICU readmission was significantly associated with lower COI.

Indexed as

AsthmaIntensive Care Units, PediatricAdolescentChildChild, PreschoolCritical IllnessFemaleHospitalizationHumansLength of StayMalePositive-Pressure RespirationRespiration, ArtificialRetrospective StudiesSeverity of Illness IndexUnited Statesasthmaneighborhoodpediatric intensive caresocial determinants of health

Identifiers

PMID41001938
PMCPMC13094558

What OpenQuestion holds

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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.