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Airway procedures and hemangiomas: treatment patterns and outcome in U.S. pediatric hospitals
Jonathan A Perkins1, Sepehr Oliaei, Michelle M Garrison
1Division of Pediatric Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, 4800 Sand Point Way N.E., Seattle, WA 98105, USA. jonathan.perkins@seattlechildrens.org
Insights
Children with hemangiomas needing airway procedures face more therapy, readmissions, and mortality. However, surgical intervention and older age at procedure can decrease readmissions for these infants.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Surgery
- Neonatal Care
Background:
- Hemangiomas are common pediatric tumors.
- Airway hemangiomas can cause significant morbidity.
- Understanding treatment patterns is crucial for optimizing care.
Purpose of the Study:
- To compare care for children with hemangiomas who had airway procedures versus those who did not.
- To identify factors influencing therapy, readmission, and mortality in this cohort.
Main Methods:
- Retrospective cohort study of 2890 patients aged 0-18 with hemangiomas.
- Data sourced from 33 US pediatric hospital discharge records (2001-2005).
- Outcomes analyzed: therapy, readmission, and mortality.
Main Results:
- 12% of patients (337) underwent airway procedures, primarily in infants aged 1-11 months.
- Airway procedure patients showed higher steroid use (80%), readmission (30%), and mortality (2%).
- Surgical procedures and age >4 months correlated with decreased readmissions; systemic steroids increased readmissions.
Conclusions:
- Children with hemangiomas requiring airway procedures need more intensive medical and surgical management.
- While readmissions are higher in this group, surgical intervention and older age at procedure are protective factors.
- Systemic steroid use is linked to increased readmissions in pediatric hemangioma patients undergoing airway procedures.
Objective:
Characterize and compare care in children with hemangiomas, who do or do not undergo airway procedures.
Methods:
National retrospective cohort study of patients aged 0-18 with hemangiomas, from 33 freestanding United States pediatric hospital discharge records, 2001-2005. The main outcome measures were therapy, readmission and mortality.
Results:
Of 2890 patients diagnosed with hemangiomas, 337 (12%) underwent airway procedures. Most airway procedures were for patients between ages 1 and 11 months. Patients with hemangiomas and airway procedures had more steroid use (80%), increased readmission (30%), and increased mortality (2%) compared to hemangioma patients without airway procedures. Procedures (i.e. laser, open surgery, tracheotomy) and age over 4 months in airway procedure patients were associated with decreased readmission. Increased readmissions were associated with systemic steroid administration.
Conclusion:
Hemangioma patients who undergo airway procedures experience increased medical and surgical therapy compared to those who do not. Readmission is increased in patients with hemangiomas and airway procedures, but surgical intervention and age greater than 4 months decreased readmission.
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