Author(s)
Ronak Rahmanian, MD
Nour K Bundogji, BA
Kastley Marvin, MD
Matthew T Brigger, MD, MPH
Affiliation(s)
University of California San Diego; CA
Abstract:
Objective: With advances in technology and management of premature infants with prolonged endotracheal intubation, laryngeal stenosis has become increasingly prevalent. There are, however reports of decreased incidence of iatrogenic laryngeal stenosis due to recent changes in the neonatal practice. This provides an opportunity for epidemiologic evaluation of the affected pediatric population with the goal of identifying measures to further improve care. Study Design: Population level database analysis Methods: The Pediatric-Health-Information-System provides data on 48 participating US children’s hospitals. Pediatric patients diagnosed with laryngeal stenosis from 10/1/2010 to 12/31/2016 were identified by corresponding ICD-9 diagnosis codes. Database analysis generated summary statistics. Regression analysis was performed to identify patient characteristics associated with this diagnosis and the associated rate of procedures. Results: 8782 pediatric patients (mean age 2.9 ±5.1 years) were diagnosed with laryngeal stenosis between 2010 to 2016. Of these, 2243 underwent airway procedures and 1371 underwent a tracheostomy. The estimated prevalence of hospitalization was 265 (95%CI: 249; 277). The incidence of laryngeal stenosis was higher in the male Caucasian population (p<0.0001). The overall mean LOS was 31.98 days, with no significant difference across regions. Total inpatient costs were $1,197,861,427 with a significant increase in cost per year (p=0.02) & a mean cost per admission of $80,904. Conclusion: Despite well-documented successes in prevention and rate reduction, laryngeal stenosis presents a considerable public health burden. Analysis of the affected patient population & comparison of the various systems may allow a targeted approach in decreasing the overall burden to families & the healthcare system.