TY - JOUR
T1 - Estimations of Laryngotracheal Stenosis After Mechanical Ventilation
T2 - A Cross-Sectional Analysis
AU - Johnson, Romaine F.
AU - Bradshaw, Stanley
AU - Jaffal, Hussein
AU - Chorney, Stephen R.
N1 - Publisher Copyright:
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Laryngotracheal stenosis
KW - mechanical intubation
KW - Nationwide Readmission Database
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U2 - 10.1002/lary.29866
DO - 10.1002/lary.29866
M3 - Article
C2 - 34542167
AN - SCOPUS:85115143680
SN - 0023-852X
JO - Laryngoscope
JF - Laryngoscope
ER -