{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:33:36Z","timestamp":1792564416636,"version":"4.5.0"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The incidence, as well as the predictors of mortality, for children receiving home mechanical ventilation (HMV) using population-based data in Canada is a current knowledge gap. Our objectives were to describe HMV incidence and mortality rates, and associations of demographic and clinical variables on mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Using Ontario health and demographic administrative databases, we conducted a retrospective cohort study (April 1, 2003\u2013March 31, 2017) of children aged 0 to 17 years receiving HMV via invasive mechanical ventilation and noninvasive ventilation. We identified children with complex chronic conditions. We used data from Census Canada to calculate incidence rates and Cox proportional hazards modeling to assess for predictors of mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We identified 906 children with a mean (SD) crude incidence rate of 2.4 (0.6) per 100\u2009000 for pediatric HMV approvals that increased by 37% over the 14-year study period. Compared with children who were invasively ventilated, we found mortality was associated with noninvasive ventilation (adjusted hazard ratio [aHR], 1.9; 95% confidence interval [CI], 1.3\u20132.8). Mortality was highest in children from families in the lowest income quintile (aHR, 2.5; 95% CI, 1.5\u20134.0), those with neurologic impairment complex chronic conditions (aHR, 2.9; 95% CI, 1.4\u20136.4), those aged 11 to 17 years at HMV initiation (aHR, 1.5; 95% CI, 1.1\u20132.0), and those with higher health care costs in the 1 year before HMV initiation (aHR, 1.5; 95% CI, 1.3\u20131.7).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The incidence of children receiving HMV increased substantially over the 14-year period. Demographic variables associated with increased mortality were identified, suggesting areas requiring greater attention for care providers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-059898","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T08:05:50Z","timestamp":1678435550000},"source":"Crossref","is-referenced-by-count":23,"title":["Incidence and Mortality of Children Receiving Home Mechanical Ventilation"],"prefix":"10.1542","volume":"151","author":[{"given":"Reshma","family":"Amin","sequence":"first","affiliation":[{"name":"aDivision of Respiratory Medicine, Department of Pediatrics, SickKids Research Institute"},{"name":"bThe Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Verma","sequence":"additional","affiliation":[{"name":"aDivision of Respiratory Medicine, Department of Pediatrics, SickKids Research Institute"},{"name":"bThe Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Qing","family":"Bai","sequence":"additional","affiliation":[{"name":"cInstitute of Health Policy, Management and Evaluation, Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Cohen","sequence":"additional","affiliation":[{"name":"dDepartment of Pediatrics, The Hospital for Sick Children, SickKids Research Institute, Institute for Clinical Evaluative Sciences, Edwin S.H Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Guttmann","sequence":"additional","affiliation":[{"name":"dDepartment of Pediatrics, The Hospital for Sick Children, SickKids Research Institute, Institute for Clinical Evaluative Sciences, Edwin S.H Leong Centre for Healthy Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea S.","family":"Gershon","sequence":"additional","affiliation":[{"name":"eDepartment of Respirology & Clinical Immunology, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherri Lynne","family":"Katz","sequence":"additional","affiliation":[{"name":"fChildren\u2019s Hospital of Eastern Ontario, Children\u2019s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Lim","sequence":"additional","affiliation":[{"name":"gDepartment of Pediatrics, McMaster Children\u2019s Hospital, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Rose","sequence":"additional","affiliation":[{"name":"hFlorence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King\u2019s College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"issue":"11","key":"2023111014070261100_B1","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1136\/adc.2010.192864","article-title":"Children on long-term ventilatory support: 10 years of progress","volume":"96","author":"Wallis","year":"2011","journal-title":"Arch Dis Child"},{"issue":"9","key":"2023111014070261100_B2","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1136\/archdischild-2012-303062","article-title":"Long-term ventilation in children: longitudinal trends and outcomes","volume":"98","author":"McDougall","year":"2013","journal-title":"Arch Dis 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