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Resource utilization and national demographics of laryngotracheal trauma in children
Michael E McCormick1, Thomas M Fissenden2, Robert H Chun1
1Department of Otolaryngology, Medical College of Wisconsin, Milwaukee.
Insights
Pediatric laryngotracheal trauma is rare, affecting older males and leading to prolonged hospital stays, multiple procedures, and high costs. This study quantizes the significant resource utilization associated with these injuries.
Area of Science:
- Pediatric Trauma Surgery
- Otolaryngology
- Health Services Research
Background:
- Pediatric laryngotracheal trauma, though infrequent, incurs substantial morbidity and healthcare costs.
- Previous investigations have not comprehensively detailed the economic impact and resource demands of these injuries in children.
Purpose of the Study:
- To establish normative data for pediatric laryngotracheal trauma using a national administrative database.
- To specifically analyze the associated costs and resource utilization for pediatric laryngotracheal trauma.
Main Methods:
- Retrospective analysis of the Kids' Inpatient Database (KID) from 2009.
- Inclusion criteria focused on International Classification of Diseases, Ninth Revision, Clinical Modification codes for laryngeal and tracheal fractures or open wounds.
- Data extracted included demographics, length of stay, diagnoses, procedures, and total charges.
Main Results:
- 106 pediatric admissions met inclusion criteria, with a mean age of 15.9 years and 79% males.
- Average length of stay was 8.4 days, with over 50% exceeding 4 days.
- Mean total charges were $90,879, with one-third of patients exceeding $100,000; common procedures included laryngoscopy and surgical repair, with tracheostomy in 30 patients.
Conclusions:
- Pediatric laryngotracheal trauma is a rare condition predominantly affecting older children.
- These injuries necessitate lengthy hospitalizations, numerous medical procedures, and significant healthcare resource consumption.
- Findings highlight the considerable economic burden and resource intensity associated with pediatric laryngotracheal trauma.
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.
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