Estimations of Laryngotracheal Stenosis After Mechanical Ventilation: A Cross-Sectional Analysis

Romaine F Johnson, Stanley Bradshaw, Hussein Jaffal, Stephen R. Chorney

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives/Hypothesis: To estimate the incidence of laryngotracheal stenosis among adults after intubation. Study Design: Cross-sectional analysis. Methods: We used the Nationwide Readmission Database to examine adult patients readmitted within 45 days after admission for mechanical ventilation. Those with a diagnosis of laryngotracheal stenosis or tracheostomy dependence on their index admission were excluded. Patient demographics, associated comorbidities, and intubation lengths were compared among those with and without a diagnosis of airway stenosis at readmission. Results: An estimated 624,918 patients met inclusion with a mean age of 59 years (standard error = 0.2). There were 1,230 patients readmitted within 45 days and diagnosed with laryngeal (N = 362) or tracheal stenosis (N = 920) estimating an incidence of 1.98 per 1,000 discharges. Compared with those without a diagnosis of airway stenosis, those with stenosis were younger (57 vs. 59 years, P <.001), more often female (62% vs. 45%, P <.001) and frequently intubated for >96 hours (47% vs. 32%, P <.001). Additionally, a history of respiratory failure, pneumonia, obesity, gastroesophageal reflux disease, and chronic steroid use were also more common among patients with stenosis. Multiple logistic regression analysis identified a decreased risk of stenosis with advancing age while an increased risk was associated strongest for females (odds ratio [OR]: 1.96, 95% confidence interval [CI]: 1.58–2.44, P <.001) and those with chronic steroid use (OR: 2.69, 95% CI: 1.80–4.02, P <.001). Conclusion: The incidence of laryngotracheal stenosis after intubation in adults is rare but is associated with female gender and younger age. Level of Evidence: N/A Laryngoscope, 2021.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - 2021

Keywords

  • Laryngotracheal stenosis
  • mechanical intubation
  • Nationwide Readmission Database

ASJC Scopus subject areas

  • Otorhinolaryngology

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