{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T14:09:30Z","timestamp":1768486170121,"version":"3.49.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>An increasing number of children survive after acute respiratory distress syndrome (ARDS). The long-term morbidity affecting these survivors, including the burden of hospital readmission and key factors associated with readmission, is unknown.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine 1-year readmission rates among survivors of pediatric ARDS and to investigate the associations of 3 key index hospitalization factors (presence or development of a complex chronic condition, receipt of a tracheostomy, and hospital length of stay [LOS]) with readmission.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective cohort study used data from the commercial or Medicaid IBM MarketScan databases between 2013 and 2017, with follow-up data through 2018. Participants included hospitalized children (aged \u226528 days to &amp;lt;18 years) who received mechanical ventilation and had algorithm-identified ARDS. Data analysis was completed from March 2022 to March 2023.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Complex chronic conditions (none, nonrespiratory, and respiratory), receipt of tracheostomy, and index hospital LOS.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was 1-year, all-cause hospital readmission. Univariable and multivariable Cox proportional hazard models were created to test the association of key hospitalization factors with readmission.<\/jats:p><\/jats:sec>Results<\/jats:title>One-year readmission occurred in 3748 of 13\u202f505 children (median [IQR] age, 4 [0-14] years; 7869 boys [58.3%]) with mechanically ventilated ARDS who survived to hospital discharge. In survival analysis, the probability of 1-year readmission was 30.0% (95% CI, 29.0%-30.8%). One-half of readmissions occurred within 61 days of discharge (95% CI, 56-67 days). Both respiratory (adjusted hazard ratio [aHR],\u20092.69; 95% CI, 2.42-2.98) and nonrespiratory (aHR,\u20091.86; 95% CI, 1.71-2.03) complex chronic conditions were associated with 1-year readmission. Placement of a new tracheostomy (aHR, 1.98; 95% CI, 1.69-2.33) and LOS 14 days or longer (aHR,\u20091.87; 95% CI, 1.62-2.16) were associated with readmission. After exclusion of children with chronic conditions, LOS 14 days or longer continued to be associated with readmission (aHR,\u20091.92; 95% CI, 1.49-2.47).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this retrospective cohort study of children with ARDS who survived to discharge, important factors associated with readmission included the presence or development of chronic medical conditions during the index admission, tracheostomy placement during index admission, and index hospitalization of 14 days or longer. Future studies should evaluate whether postdischarge interventions (eg, telephonic contact, follow-up clinics, and home health care) may help reduce the readmission burden.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.30774","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T15:30:59Z","timestamp":1694187059000},"page":"e2330774","source":"Crossref","is-referenced-by-count":8,"title":["Readmission Rates After Acute Respiratory Distress Syndrome in Children"],"prefix":"10.1001","volume":"6","author":[{"given":"Garrett","family":"Keim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse Y.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neethi P.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan L.","family":"McSherry","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annie Laurie","family":"Gula","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason D.","family":"Christie","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadir","family":"Yehya","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2023,9,8]]},"reference":[{"issue":"2","key":"zoi230885r1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.7322\/jhgd.103014","article-title":"Clinical-epidemiological profile of hospitalised patients in paediatric intensive care unit.","volume":"25","author":"Batista","year":"2015","journal-title":"J Hum Growth Dev"},{"issue":"5","key":"zoi230885r2","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1001\/jamapediatrics.2023.0184","article-title":"Epidemiology of intensive care admissions for children in the US from 2001 to 2019.","volume":"177","author":"Killien","year":"2023","journal-title":"JAMA 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