378: NEIGHBORHOOD OPPORTUNITY IN CHILDREN ADMITTED TO THE PEDIATRIC INTENSIVE CARE UNIT

Abstract

Learning Objectives: The Childhood Opportunity Index (COI) is a publicly available metric that collates multiple social, economic, environmental and educational variables associated with child well-being and healthy development. The COI is available for 100 U.S. metropolitan areas (datadiversitykids.org). The aim of this study was to use the COI to explore the demographics of critically ill children admitted to an urban, tertiary pediatric intensive care unit (PICU). Methods: With IRB approval, a convenience sample of 250 children ≤ 18 years old sequentially admitted to our PICU starting in January 2016 were identified using local Virtual PICU (VPS, LLC) data and the electronic medical record. Demographics and length of stay (LOS) were collected. Patients were excluded if COI data were not available. Patient addresses were geocoded to census tracts, which were then matched to COI data. Patients were classified as living within one of 5 quintiles of neighborhood opportunity (very low, low, moderate, high or very high). Statistical methods included descriptive statistics and Wilcoxon rank-sum. Data shown as n (%) or median (interquartile range). Results: There were 188 children included in this study. The median age was 37.5 (8.0–166.0) months; 99 (53%) were African American, and 87 (46%) were Caucasian. PICU LOS was 1.2 (0.8– 2.9) days. The most common discharge diagnoses were respiratory infections (including bronchiolitis) (31%), asthma (10%), seizures (6%), diabetic ketoacidosis (5%) and poisoning (5%). In this cohort, 94 (50%) children were living in either a very low or low opportunity neighborhood. There was no difference in PICU LOS between these children and those living in moderate, high, or very high opportunity communities (1.01 days [0.78–1.96] vs 1.39 [0.80–3.97], p=0.062). Conclusions: The COI may be a useful metric for identifying social, economic, environmental and educational variables associated with health outcomes in critically ill children, and warrants further investigation.