2023
Effect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay.
Winer J, Richardson T, Berg K, Berry J, Chang P, Etinger V, Hall M, Kim G, Meneses Paz J, Treasure J, Aronson P. Effect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay. Hospital Pediatrics 2023, 13: 1018-1027. PMID: 37795554, PMCID: PMC10593863, DOI: 10.1542/hpeds.2023-007295.Peer-Reviewed Original ResearchMeSH KeywordsBronchiolitisCannulaHumansInfantLength of StayOxygen Inhalation TherapyRetrospective StudiesConceptsEffect of HFNCICU servicesEffect modifiersHigh-flow nasal cannula therapyMulticenter retrospective cohort studyPediatric Health Information SystemAge groupsHigh-flow nasal cannulaNon-ICU patientsRetrospective cohort studyComplex chronic conditionsMultivariable Poisson regressionFuture prospective studiesPotential effect modifiersInitial desaturationInitial tachypneaCohort studyClinical factorsNasal cannulaHospital recordsProspective studyHospitalized childrenChronic conditionsHFNCPatientsRacial and Ethnic Differences in Insurer Classification of Nonemergent Pediatric Emergency Department Visits
Pomerantz A, De Souza H, Hall M, Neuman M, Goyal M, Samuels-Kalow M, Aronson P, Alpern E, Simon H, Hoffmann J, Wells J, Shanahan K, Gutman C, Peltz A. Racial and Ethnic Differences in Insurer Classification of Nonemergent Pediatric Emergency Department Visits. JAMA Network Open 2023, 6: e2311752. PMID: 37140920, PMCID: PMC10160869, DOI: 10.1001/jamanetworkopen.2023.11752.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildEmergency Service, HospitalEthnicityHumansInsurance CarriersMedicaidRetrospective StudiesUnited StatesConceptsUnique ED visitsED visitsPediatric ED visitsClaims algorithmHispanic childrenMore visitsReimbursement reductionsHispanic pediatric patientsNonemergent ED visitsCurrent Procedural Terminology codesEmergency department visitsPediatric emergency departmentPrimary care servicesProcedural Terminology codesWhite childrenProfessional reimbursementCommercial health insurerRetrospective cohortDate of birthDepartment visitsPediatric patientsStudy cohortEmergency departmentMedicaid databaseDiagnosis codesVariation in stool testing for children with acute gastrointestinal infections
Markham J, Hall M, Collins M, Shah S, Molloy M, Aronson P, Cotter J, Steiner M, McCoy E, Tchou M, Stephens J. Variation in stool testing for children with acute gastrointestinal infections. Journal Of Hospital Medicine 2023, 18: 473-482. PMID: 36988413, PMCID: PMC11340271, DOI: 10.1002/jhm.13087.Peer-Reviewed Original ResearchMeSH KeywordsChildCommunicable DiseasesCross-Sectional StudiesHumansLength of StayRetrospective StudiesConceptsAcute gastrointestinal infectionsStool testingLength of stayGastrointestinal infectionsHospitalized childrenTesting ratesUtilization outcomesPediatric Health Information System databaseHealth Information System databaseOverall testing rateCross-sectional studyStool studiesDiagnostic stewardshipAcute careChildren's HospitalInformation System databaseMAIN OUTCOMEHospitalInfectionIndividual hospitalsOutcomesSignificant differencesChildrenSystem databaseTesting group
2022
Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic.
Aronson P, Kerns E, Jennings B, Magee S, Wang M, McDaniel C. Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic. Pediatrics 2022, 150 PMID: 36353853, DOI: 10.1542/peds.2022-059235.Peer-Reviewed Original ResearchConceptsUrinary tract infectionInvasive bacterial infectionsCOVID-19 prevalenceFebrile infantsOdds of UTIPrevalence of UTIBacterial infectionsMulticenter cross-sectional studyEmergency department visitsMonths of presentationCoronavirus disease 2019 (COVID-19) pandemicCross-sectional studyDisease 2019 pandemicUTI prevalenceTract infectionsBacterial meningitisDepartment visitsLower oddsPrepandemic levelsInfantsInfants 8MeningitisBacteremiaLogistic regressionPrevalenceInjury-Related Pediatric Emergency Department Visits in the First Year of COVID-19.
Wells J, Rodean J, Cook L, Sills M, Neuman M, Kornblith A, Jain S, Hirsch A, Goyal M, Fleegler E, DeLaroche A, Aronson P, Leonard J. Injury-Related Pediatric Emergency Department Visits in the First Year of COVID-19. Pediatrics 2022, 150 PMID: 35836331, DOI: 10.1542/peds.2021-054545.Peer-Reviewed Original ResearchMeSH KeywordsChildCOVID-19Cross-Sectional StudiesEmergency Service, HospitalHumansPandemicsRetrospective StudiesSARS-CoV-2United StatesConceptsInjury-related visitsInjury-related ED visitsHospital emergency departmentEmergency departmentED visitsSARS-CoV-2 pandemic periodAcute respiratory syndrome coronavirus 2 pandemicSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemicChildren's hospital emergency departmentPediatric Health Information SystemUnited States children's hospitalsPrimary discharge diagnosisMechanism of injurySprains/strainsPediatric emergency departmentCoronavirus 2 pandemicCross-sectional studySARS-CoV-2 pandemicFirst yearPatient characteristicsChildren's HospitalDischarge diagnosisInjury patternsInjury typeAdministrative databasesPrevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months
Green R, Sartori L, Lee B, Linn A, Samuels M, Florin T, Aronson P, Chamberlain J, Michelson K, Nigrovic L. Prevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months. Annals Of Emergency Medicine 2022, 80: 499-506. PMID: 35940993, DOI: 10.1016/j.annemergmed.2022.06.014.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBacteriaBacterial InfectionsCase-Control StudiesFeverHumansInfantInfant, NewbornPrevalenceRetrospective StudiesConceptsInvasive bacterial infectionsCase-control studyBacterial infectionsFebrile infantsInfants 2Emergency departmentEligible patient encountersOlder febrile infantsCerebrospinal fluid culturesInfection prevalenceAge-matched infantsEvidence-based guidelinesInfants ages 2Months of ageLow-value testingFebrile neonatesOverall cohortRetrospective cohortSecondary outcomesPrimary outcomeAntibiotic administrationBacterial cultureFluid cultureCerebrospinal fluidLower risk
2018
Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture
Aronson PL, Wang ME, Shapiro ED, Shah SS, DePorre AG, McCulloh RJ, Pruitt CM, Desai S, Nigrovic LE, Marble RD, Leazer RC, Rooholamini SN, Sartori LF, Balamuth F, Woll C, Neuman MI. Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture. Pediatrics 2018, 142: e20181879. PMID: 30425130, PMCID: PMC6317769, DOI: 10.1542/peds.2018-1879.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsPhiladelphia criteriaFebrile infantsBacterial meningitisRisk stratificationCSF testingRochester criteriaEmergency departmentLower riskRoutine CSF testingCerebrospinal fluid testingComplex chronic conditionsRoutine lumbar punctureCase-control studyDate of visitLow-risk infantsLumbar punctureChronic conditionsHigh riskInfantsBacterial infectionsDay oldsFluid testingMeningitisRiskFactors Associated with Adverse Outcomes among Febrile Young Infants with Invasive Bacterial Infections
Pruitt CM, Neuman MI, Shah SS, Shabanova V, Woll C, Wang ME, Alpern ER, Williams DJ, Sartori L, Desai S, Leazer RC, Marble RD, McCulloh RJ, DePorre AG, Rooholamini SN, Lumb CE, Balamuth F, Shin S, Aronson PL, Collaborative F, Nigrovic L, Browning W, Mitchell C, Peaper D, Feldman E. Factors Associated with Adverse Outcomes among Febrile Young Infants with Invasive Bacterial Infections. The Journal Of Pediatrics 2018, 204: 177-182.e1. PMID: 30297292, PMCID: PMC6309646, DOI: 10.1016/j.jpeds.2018.08.066.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBacteremiaCohort StudiesFemaleFeverHumansInfantInfant MortalityInfant, NewbornMaleMeningitis, BacterialRetrospective StudiesRisk FactorsConceptsInvasive bacterial infectionsFebrile young infantsAdverse outcomesBacterial meningitisYoung infantsIll appearanceFebrile infantsBacterial infectionsRetrospective cohort studyMedical record reviewLocal microbiology laboratoryMixed-effects logistic regressionElectronic medical record systemDays of ageIll appearingNeurologic sequelaeCohort studyMedical record systemClinical factorsMedication receiptMechanical ventilationRecord reviewClinical dataInclusion criteriaMeningitisEpidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments
Woll C, Neuman MI, Pruitt CM, Wang ME, Shapiro ED, Shah SS, McCulloh RJ, Nigrovic LE, Desai S, DePorre AG, Leazer RC, Marble RD, Balamuth F, Feldman EA, Sartori LF, Browning WL, Aronson PL, Collaborative F, Alpern E, Hayes K, Lee B, Lumb C, Mitchell C, Peaper D, Rooholamini S, Shin S, Williams D. Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments. The Journal Of Pediatrics 2018, 200: 210-217.e1. PMID: 29784512, PMCID: PMC6109608, DOI: 10.1016/j.jpeds.2018.04.033.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsThird-generation cephalosporinsMicrobiology laboratory databaseEmergency departmentBacterial infectionsBacterial meningitisPediatric emergency departmentCombination of ampicillinAntimicrobial treatment regimenCross-sectional studyGroup B streptococciElectronic medical record systemEmpiric treatmentMedical record systemTreatment regimenChildren's HospitalMost infantsMedical recordsB streptococciCerebrospinal fluidCommon pathogensInfantsAntimicrobial susceptibilityDay oldsInfection
2017
Impact of Enteroviral Polymerase Chain Reaction Testing on Length of Stay for Infants 60 Days Old or Younger
Aronson PL, Lyons TW, Cruz AT, Freedman SB, Okada PJ, Fleming AH, Arms JL, Thompson AD, Schmidt SM, Louie J, Alfonzo MJ, Monuteaux MC, Nigrovic LE, Group P, Alpern E, Balamuth F, Bradin S, Curtis S, Garro A, Grether-Jones K, Ishimine P, Kulik D, Mahajan P, Miller A, Mistry R, Pruitt C, Schnadower D, Shah S, Thomson J, Uspal N. Impact of Enteroviral Polymerase Chain Reaction Testing on Length of Stay for Infants 60 Days Old or Younger. The Journal Of Pediatrics 2017, 189: 169-174.e2. PMID: 28705656, PMCID: PMC5870831, DOI: 10.1016/j.jpeds.2017.06.021.Peer-Reviewed Original ResearchConceptsPCR testShorter LOSCentral nervous system infectionPolymerase chain reaction testingCerebrospinal fluid culturesNervous system infectionPlanned secondary analysisLarge multicenter cohortCerebrospinal fluid evaluationLength of stayPositive test resultsNegative test resultsDays of ageHospital lengthHospital LOSRetrospective cohortSystem infectionBacterial meningitisMulticenter cohortPatient ageFluid cultureHospital CenterPCR testingReaction testingInfants
2015
Association between Clinical Outcomes and Hospital Guidelines for Cerebrospinal Fluid Testing in Febrile Infants Aged 29-56 Days
Chua KP, Neuman MI, McWilliams JM, Aronson PL, Collaborative F, Thurm C, Williams D, Browning W, Nigrovic L, Alpern E, Tieder J, Feldman E, Shah S, Schondelmeyer A, Alessandrini E, McCulloh R, Myers A, Balamuth F, Hayes K. Association between Clinical Outcomes and Hospital Guidelines for Cerebrospinal Fluid Testing in Febrile Infants Aged 29-56 Days. The Journal Of Pediatrics 2015, 167: 1340-1346.e9. PMID: 26477870, PMCID: PMC5535778, DOI: 10.1016/j.jpeds.2015.09.021.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesOlder febrile infantsFebrile infantsCerebrospinal fluid testingClinical outcomesCSF testingAdverse eventsFluid testingYoung febrile infantsCentral venous cathetersUS children's hospitalsSignificant differencesMedian annual household incomeRace/ethnicityAnnual household incomeHospital mortalityVenous cathetersBacterial meningitisMembrane oxygenationPrimary outcomeHospital guidelinesMechanical ventilationChildren's HospitalEmergency departmentPractice guidelinesAssociation of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age
Aronson PL, Thurm C, Williams DJ, Nigrovic LE, Alpern ER, Tieder JS, Shah SS, McCulloh RJ, Balamuth F, Schondelmeyer AC, Alessandrini EA, Browning WL, Myers AL, Neuman MI, Collaborative F. Association of clinical practice guidelines with emergency department management of febrile infants ≤56 days of age. Journal Of Hospital Medicine 2015, 10: 358-365. PMID: 25684689, PMCID: PMC4456211, DOI: 10.1002/jhm.2329.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsBlood Chemical AnalysisCeftriaxoneCerebrospinal FluidCost ControlCross-Sectional StudiesEmergency Service, HospitalFeverGuideline AdherenceHealth Care SurveysHealth Information SystemsHospitals, PediatricHumansInfantInfant, NewbornPractice Guidelines as TopicRetrospective StudiesUnited StatesUrinalysisConceptsClinical practice guidelinesCeftriaxone useCPG recommendationsInfants 29CSF testingHealthcare costsED dischargeFebrile infantsPractice guidelinesInstitutional clinical practice guidelinePediatric Health Information SystemRetrospective cross-sectional studyCerebrospinal fluid testingEmergency department managementCross-sectional studyLower healthcare costsRate of urineDiagnosis of feverDays of ageED visitsPractice variationDepartment managementAge groupsHealth information systemsFluid testing
2014
Variation in Care of the Febrile Young Infant <90 Days in US Pediatric Emergency Departments
Aronson PL, Thurm C, Alpern ER, Alessandrini EA, Williams DJ, Shah SS, Nigrovic LE, McCulloh RJ, Schondelmeyer A, Tieder JS, Neuman MI. Variation in Care of the Febrile Young Infant <90 Days in US Pediatric Emergency Departments. Pediatrics 2014, 134: 667-677. PMID: 25266437, DOI: 10.1542/peds.2014-1382.Peer-Reviewed Original ResearchConceptsFebrile young infantsPediatric emergency departmentUS pediatric emergency departmentsHospital-level variationEmergency departmentHospitalization ratesInterhospital variationYoung infantsAge groupsSignificant interhospital variationRetrospective cohort studyCerebrospinal fluid testingProportion of patientsQuality of careDays of ageInfants 29Substantial patientCohort studyED visitsOverall cohortPatient ageED managementDiagnosis codesInclusion criteriaModifiable source