74 A rural perspective of severe acute respiratory admissions: Clinical characteristics and outcomes of children hospitalized in rural communities from 2022-2023, the READAPT-Kids study cohort
Bibliographic record
Abstract
Abstract Background As public health guidelines relaxed following the SARS-CoV2 pandemic, the 2022-2023 respiratory viral season brought crisis to Canada’s paediatric hospitals due to a surge in admissions for severe acute respiratory illnesses (SARI). This included the most common reasons for paediatric admissions, such as bronchiolitis, asthma and pneumonia. The effect on rural hospitals was profound, but limited data is available. Children in rural and remote communities may experience greater barriers to care and worse outcomes compared with those in urban centres, but descriptions of their experiences are limited. Objectives To describe transportation pathways, clinical presentations, interventions and outcomes of children admitted to rural and regional hospitals with severe acute respiratory illnesses (SARI) during the 2022-2023 season. Design/Methods An observational cohort study of children and youth less than 18 years hospitalized with SARI from July 1, 2022 to June 30, 2023 at 3 regional hospitals within a single health authority, spanning a geographical area of 600,000 square kilometres. This was a subgroup analysis of the larger READAPT-Kids study cohort (clinical chaRacteristics and outcomEs of hospitAlized chilDren with Acute resPiratory infecTions). Cases were identified using ICD-10-CA codes, then manually screened for inclusion criteria. Detailed clinical, demographic and transport information was extracted. Results A total of 203 children were admitted with SARI to either the regional centre (n=137) or 2 other community hospitals (n=29; n=37) during the study period. Of these admissions, 25% (n=51) were transported from a peripheral site and 3% (n=6) required transport from two or more healthcare facilities before arriving at the final treating hospital. Referring sites included remote health clinics and local community hospitals. 40% (n=82) required significant respiratory support, including high flow nasal cannula oxygen (34%, n=70), BiPAP (3%, n=5) or CPAP (3%, n=5). On admission, 48% (n=98) were prescribed antimicrobial therapy, 10% (n=21) were treated with antivirals, and 67% (n=135) received corticosteroids. A total of 5% (n=10) of children were subsequently transported by air to a provincial paediatric intensive care unit (PICU) for critical care support. Upon discharge, 40% (n=80/197) had scheduled paediatric follow-up. Conclusion Almost half of the children admitted with SARI in northern community hospitals required a significant level of respiratory support, but only 5% required transfer to a PICU for intensive care. Rural and regional centres provide a critical role in caring for paediatric patients. More research is needed to help advocate for this patient population and the healthcare providers caring for them.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".