Resource Utilization and National Demographics of Laryngotracheal Trauma in Children | Adolescent Medicine | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.175.212.130. Please contact the publisher to request reinstatement.
1.
Oosthuizen  JC.  Paediatric blunt laryngeal trauma: a review.  Int J Otolaryngol. 2011;2011:183047.PubMedGoogle ScholarCrossref
2.
Sidell  D, Mendelsohn  AH, Shapiro  NL, St John  M.  Management and outcomes of laryngeal injuries in the pediatric population.  Ann Otol Rhinol Laryngol. 2011;120(12):787-795.PubMedGoogle Scholar
3.
Merritt  RM, Bent  JP, Porubsky  ES.  Acute laryngeal trauma in the pediatric patient.  Ann Otol Rhinol Laryngol. 1998;107(2):104-106.PubMedGoogle Scholar
4.
Shah  RK.  Unlocking the value in administrative databases.  Laryngoscope. 2012;122(suppl 4):S65-S66.PubMedGoogle ScholarCrossref
5.
Healthcare Cost and Utilization Project (HCUP).  Introduction to the HCUP Kids' Inpatient Database (KID) 2009. Rockville, MD: Agency for Healthcare Research and Quality; 2011.
6.
McCormick  ME, Chun  RH, Lander  L, Shah  RK.  Socioeconomic implications of pediatric cervical methicillin-resistant Staphylococcus aureus infections.  JAMA Otolaryngol Head Neck Surg. 2013;139(2):124-128.PubMedGoogle ScholarCrossref
7.
Shah  RK, Lander  L, Choi  SS, Zalzal  GH.  Resource utilization in the management of subglottic stenosis.  Otolaryngol Head Neck Surg. 2008;138(2):233-241.PubMedGoogle ScholarCrossref
8.
Ford  HR, Gardner  MJ, Lynch  JM.  Laryngotracheal disruption from blunt pediatric neck injuries: impact of early recognition and intervention on outcome.  J Pediatr Surg. 1995;30(2):331-334.PubMedGoogle ScholarCrossref
9.
Gold  SM, Gerber  ME, Shott  SR, Myer  CM  III.  Blunt laryngotracheal trauma in children.  Arch Otolaryngol Head Neck Surg. 1997;123(1):83-87.PubMedGoogle ScholarCrossref
10.
Hackett  AM, Chi  D, Kitsko  DJ.  Patterns of injury and otolaryngology intervention in pediatric neck trauma.  Int J Pediatr Otorhinolaryngol. 2012;76(12):1751-1754.PubMedGoogle ScholarCrossref
11.
Shires  CB, Preston  T, Thompson  J.  Pediatric laryngeal trauma: a case series at a tertiary children’s hospital.  Int J Pediatr Otorhinolaryngol. 2011;75(3):401-408.PubMedGoogle ScholarCrossref
12.
Wootten  CT, Bromwich  MA, Myer  CM  III.  Trends in blunt laryngotracheal trauma in children.  Int J Pediatr Otorhinolaryngol. 2009;73(8):1071-1075.PubMedGoogle ScholarCrossref
13.
Alonso  WA, Caruso  VG, Roncace  EA.  Minibikes, a new factor in laryngotracheal trauma.  Ann Otol Rhinol Laryngol. 1973;82(6):800-804.PubMedGoogle Scholar
Original Investigation
September 2014

Resource Utilization and National Demographics of Laryngotracheal Trauma in Children

Author Affiliations
  • 1Department of Otolaryngology, Medical College of Wisconsin, Milwaukee
  • 2Department of Otolaryngology, George Washington University, Washington, DC
  • 3Department of Epidemiology, University of Nebraska Medical Center, Omaha
  • 4Division of Pediatric Otolaryngology, Children’s National Medical Center, Washington, DC
JAMA Otolaryngol Head Neck Surg. 2014;140(9):829-832. doi:10.1001/jamaoto.2014.1410
Abstract

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.

×