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Analysis of Vocal Fold Motion Impairment in Neonates Undergoing Congenital Heart Surgery

Stephanie E Ambrose1,2, Julina Ongkasuwan3,4, Kavita Dedhia1,2

  • 1Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia.

JAMA Otolaryngology-- Head & Neck Surgery
|March 16, 2018
PubMed

Insights

Vocal fold motion impairment (VFMI) in neonates after congenital heart surgery (CHS) significantly increases hospital costs, primarily due to longer postprocedure stays. Early detection of VFMI may reduce these costs.

Area of Science:

  • Pediatric Cardiology
  • Neonatal Surgery
  • Otolaryngology

Background:

  • Vocal fold motion impairment (VFMI) is a recognized complication following congenital heart surgery (CHS).
  • The economic and clinical impact of VFMI in neonates post-CHS remains largely uncharacterized.

Purpose of the Study:

  • To assess the association between VFMI and healthcare utilization, specifically cost and postprocedure length of stay (PPLOS).
  • To evaluate the impact of VFMI on key clinical outcomes in neonates undergoing CHS.

Main Methods:

  • A cross-sectional analysis utilized the 2012 Kids' Inpatient Database (KID).
  • Included neonates (0-28 days) who underwent CHS.
  • Compared outcomes between neonates with and without VFMI using risk-adjusted models.

Main Results:

  • Neonates with VFMI had significantly higher total costs (+$34,000) and PPLOS (+9.1 days).
  • The increased cost was primarily attributed to extended PPLOS; VFMI was not a significant cost driver when PPLOS was controlled.
  • No significant differences were observed in the odds of pneumonia, gastrostomy, or tracheostomy placement.

Conclusions:

  • VFMI following CHS is linked to substantial increases in healthcare costs, driven by prolonged hospital stays.
  • These findings support further investigation into standardized VFMI screening protocols post-CHS.
  • Early identification and management of VFMI may lead to reduced PPLOS and associated healthcare expenditures.
Abstract

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