Effect of Preferred Language on Pediatric Rapid Response Activation and Subsequent Intensive Care Utilization

Health care disparities stemming from language discordance have been well established, leading to increased morbidity and mortality. We sought to examine the effect of patient preferred language on time to rapid response activation and subsequent intensive care utilization. We sought to evaluate the association between patient preferred language and time to rapid response (RR) activation, intensive care unit (ICU) transfer rate, and intensive care utilization in a quaternary pediatric hospital. We conducted a retrospective observational study of pediatric patients with rapid response activation from January 2020 to June 2023. Demographic and clinical data, including time to rapid response, ICU transfers, and use of mechanical ventilation, non-invasive ventilation, and vasoactive support, were analyzed. Statistical comparisons were performed between English-speaking and language other than English (LOE) patients, with subgroup analyses for Spanish-speaking patients. Of 374 unique patients, 25% were using LOE. Time to rapid response activation was not significantly different between language groups. However, Spanish-speaking patients were more likely to be transferred to the ICU (P = .0047) and had longer hospital stays (10 vs 7 days, P = .0425). While language preference did not impact time to rapid response activation, Spanish-speaking patients had increased ICU transfers and prolonged hospital stays. These findings highlight the need for improved language-concordant care to mitigate disparities in pediatric critical care outcomes.