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Neonatal Macroglossia: Demographics, Cost of Care, and Associated Comorbidities
Jonathan C Simmonds1, Anju K Patel1, Nicholas R Mildenhall1
11 Department of Otolaryngology/Head and Neck Surgery, Tufts Medical Center, Boston, MA, USA.
Insights
Congenital macroglossia affects 4.63 per 100,000 births, with higher prevalence in females and African Americans. Both isolated and syndromic macroglossia significantly increase hospital stay and costs.
Area of Science:
- Pediatric Health
- Medical Genetics
- Public Health
Background:
- Congenital macroglossia is a condition characterized by an abnormally large tongue present at birth.
- Understanding its prevalence, associated factors, and healthcare implications is crucial for effective management.
Purpose of the Study:
- To determine the birth prevalence of congenital macroglossia.
- To identify demographic variables and comorbidities influencing length of stay and cost of care.
Main Methods:
- Retrospective cross-sectional study utilizing the Kids' Inpatient Database (2003-2012).
- Analysis included demographic data, multivariate analyses, and linear regression modeling.
Main Results:
- The birth prevalence was 4.63 per 100,000 births, with isolated macroglossia more common in females and African Americans.
- Syndromic macroglossia cases had significantly longer hospital stays (22.6 days) and higher costs ($36,190) compared to isolated cases (7.93 days, $10,168).
- Macroglossia independently increased length of stay by 4.07 days (nonsyndromic) and 12.02 days (syndromic), with associated cost increases of $6,207 and $17,205, respectively.
Conclusions:
- Congenital isolated macroglossia prevalence varies by sex and race.
- Both isolated and syndromic macroglossia are associated with prolonged hospital stays and increased healthcare costs, independent of other comorbidities.
Objectives:
To examine the birth prevalence of congenital macroglossia and identify demographic variables and comorbidities that may influence length of stay and cost of care.
Study Design:
Retrospective cross-sectional study using the Kids' Inpatient Database 2003, 2006, 2009, and 2012.
Methods:
Demographics were analyzed. Linear regression modeling and multivariate analyses were performed.
Results:
The birth prevalence of congenital macroglossia was 4.63/100 000 births. Patients were classified as isolated (n = 349, 48.1%) or syndromic (n = 377, 51.9%). A higher incidence of isolated macroglossia was seen in females (odds ratio, OR [95% confidence interval, 95% CI]: 1.93 [1.45-2.56] and African Americans (2.02 [1.41-2.88]). Length of stay was higher for syndromic patients than for nonsyndromic patients (22.6 days [18.6-26.6] vs 7.93 days [5.95-9.90], as were inpatient costs ($3619USD [$27 628-$44 754] vs $10 168USD [$6272-$14 064]. After accounting for gender, race, location, and socioeconomic status, the presence of macroglossia alone increased length of stay by 4.07 days (0.42-7.72 days) in nonsyndromic patients and 12.02 days (3.63-20.4 days) in syndromic patients. The cost of care increased by $6207USD ($576-$11 838) among nonsyndromic newborns and $17 205USD ($374-34 035) among syndromic patients.
Conclusion:
The birth prevalence of congenital isolated macroglossia appears to vary by sex and race. Prolonged length of stay and increased costs are associated with both isolated macroglossia and syndromic macroglossia, even after controlling for other syndromic comorbidities.
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