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Research Snapshot Theater: Epidemiology - Outcomes, Pediatric III

Social Complexity May Increase PICU Use in Chronically Ill Patients Using Respiratory Technology

Sunday, March 22, 2026
12:15 PM - 1:15 PM Central Time
Location: Connections Central - RST 17
  • RC

    Rachel A. Calautti, MD (she/her/hers)

    Children's Hospital At Montefiore, New York

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • PP

    Prachi Patel, DO

    Pediatric Medicine Resident
    Children's Hospital at Montefiore

    Disclosure information not submitted.

  • MF

    Melissa Fazzari, MS, PHD

    Associate Professor
    Albert Einstein College of Medicine

    Disclosure information not submitted.

  • YJ

    Ying Jin, MS

    Staff Scientist
    Albert Einstein College of Medicine

    Disclosure information not submitted.

  • MP

    Michelle M. Perez, MD

    Pediatric Critical Care Program Director, Assistant Professor
    Children's Hospital at Montefiore

    Disclosure information not submitted.

  • CY

    Christina Yang, MD

    Associate Professor, Director of the Aerodigestive Program at Montefiore
    Children's Hospital at Montefiore, New York

    Disclosure information not submitted.

  • MK

    Monica L. Koncicki, MD

    Assistant Professor
    Children's Hospital at Montefiore

    Disclosure information not submitted.

Introduction: Advances in pediatric critical care have shifted the pediatric intensive care (PICU) patient population to include more patients with chronic critical illness (CCI). The CCI population is known to have high PICU resource use, morbidity and mortality compared to non-CCI children. However, there are limited studies examining factors associated with increased resource use within the CCI cohort. This study aims to examine markers associated with increased PICU use for children with CCI requiring respiratory technology.


Methods: A single center retrospective chart review of pediatric patients with CCI requiring respiratory technology (tracheostomy, invasive or non-invasive ventilation) was performed. Patients receiving respiratory support for strictly OSA were excluded. Patient charts were identified using the CHDI – OHDSI ATLAS program and categorized by previously published ICD – 10 codes associated with respiratory CCI.

Data collected included demographic characteristics, Child Opportunity Index (COI) scores, comorbidities, respiratory technology used, and duration of technology use during a defined first index admission. Patients re-admitted after one-year from the first index admission but within the study period (2018-2023) were included as a separate index case. PICU days admitted and admissions within one year following all index admissions were calculated. A cumulative logistic mixed-effects regression was used to model predictors of PICU days utilized within one year of index admission.


Results: Fifty-nine patients and eighty-eight index admissions were analyzed. After adjusting for age, gender, race, ethnicity, discharge location, type and duration of respiratory technology used, and number of comorbidities, patients with high COI demonstrated a significant 94% reduction in odds of having a higher number of utilized PICU days (>15days) within one year of index admission compared to patients with very low COI (OR = 0.06, p< 0.05]. However, this trend did not extend to those with very high COI.


Conclusions: This study suggests that different levels of COI may impact PICU resource utilization. However, further investigation is warranted to further clarify this finding.