Resource utilization and national demographics of laryngotracheal trauma in children. JAMA Otolaryngol Head Neck Surg 2014 Sep;140(9):829-32
Date
08/12/2014Pubmed ID
25104298DOI
10.1001/jamaoto.2014.1410Scopus ID
2-s2.0-84907187115 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
IMPORTANCE: Pediatric laryngotracheal trauma is rare but can carry considerable morbidity and health care resource expenditure. However, the true cost of these injuries has not been thoroughly investigated.
OBJECTIVE: To use a national administrative pediatric database to identify normative data on pediatric laryngotracheal trauma, specifically with regard to cost and resource utilization.
DESIGN AND PARTICIPANTS: Retrospective medical record review using the Kids' Inpatient Database (KID) 2009. Inclusion criteria were admissions with International Classification of Diseases, Ninth Revision, Clinical Modification, codes for fractures or open wounds of the larynx and trachea.
MAIN OUTCOMES AND MEASURES: Among many data analyzed were demographic information and admission characteristics, including length of stay, diagnoses, procedures performed, and total charges.
RESULTS: There were 106 admissions that met inclusion criteria. Patient mean (SE) age was 15.9 (0.45) years, and 79% were males. The mean (SE) length of stay (LOS) was 8.4 (1.1) days; more than 50% of patients had a LOS longer than 4 days. The mean number of diagnoses per patient was 6.9 (0.6); other traumatic injuries included pneumothorax (n = 18). More than 75% of patients underwent more than 2 procedures during their admission; 60.2% underwent a major operative procedure. The most common procedures performed were laryngoscopy (n = 54) and operative repair of the larynx and/or trachea (n = 32). Tracheostomy was performed in only 30 patients. The mean (SE) total charge was $90,879 ($11,419), and one-third of patients had total charges more than $100,000.
CONCLUSIONS AND RELEVANCE: Pediatric laryngotracheal trauma remains a relatively rare clinical entity. These injuries primarily affect older children and are associated with long hospitalizations, multiple procedures, and high resource utilization.
Author List
McCormick ME, Fissenden TM, Chun RH, Lander L, Shah RKAuthors
Robert H. Chun MD Professor in the Otolaryngology department at Medical College of WisconsinMichael E. McCormick MD Associate Professor in the Otolaryngology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAge Distribution
Bronchoscopy
Databases, Factual
Deglutition Disorders
Facial Bones
Female
Hospital Charges
Humans
Intubation, Intratracheal
Laryngoscopy
Larynx
Length of Stay
Male
Respiration, Artificial
Respiratory Tract Diseases
Retrospective Studies
Sex Distribution
Subcutaneous Emphysema
Trachea
Tracheostomy
United States
