Ni Jonathan S, Kohn Jocelyn, Shah Udayan K, Levi Jessica R
Boston University School of Medicine, 72 E. Concord St., Boston, MA, 02118, USA.
Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, 820 Harrison Ave., FGH Building 4th Floor, Boston, MA, 02118, USA.
Int J Pediatr Otorhinolaryngol. 2020 Mar;130:109800. doi: 10.1016/j.ijporl.2019.109800. Epub 2019 Nov 29.
Tracheitis is an upper airway infection that often presents in patients with tracheostomies and can potentially cause airway obstruction. This study aims to use a nationwide database to identify a large cohort of pediatric patients admitted with tracheitis to elucidate the management and resource utilization associated with the disease both with and without tracheostomies.
The Kids' Inpatient Database (KID) 2012 was used to identify 2394 weighted discharges with acute tracheitis, with or without obstruction, as the primary diagnosis. Data on prior tracheostomy status, demographics, hospital characteristics, management, and resource utilization were obtained. Two groups of interest, based on presence of prior tracheostomy, were studied. Linear regression was performed to determine independent predictors of total charges.
The mean age was 5.52 years (SD: 5.54), mean length of stay (LOS) was 6.37 days (SD: 10.18), and mean total charges were $60,996.61 (SD: 107,798.41). Patients with prior tracheostomy had lower rates of endoscopy and endotracheal intubation than patients without (p < 0.0005). There was no significant difference in LOS (p = 0.076) or total charges (p = 0.210) between the groups based on prior tracheostomy status.
Pediatric tracheitis should be differentiated on the basis of tracheostomy status. We propose that tracheitis diagnosis codes should be distinguished by the presence of tracheostomy as "open" and the absence of tracheostomy as "closed."
气管炎是一种上呼吸道感染，常见于气管切开术患者，可能导致气道阻塞。本研究旨在利用全国性数据库确定一大群因气管炎入院的儿科患者，以阐明该疾病在有或无气管切开术情况下的管理及资源利用情况。
使用2012年儿童住院数据库（KID）确定2394例以急性气管炎（有或无阻塞）作为主要诊断的加权出院病例。获取有关既往气管切开术状态、人口统计学、医院特征、管理及资源利用的数据。基于既往气管切开术的存在情况，研究两组感兴趣的对象。进行线性回归以确定总费用的独立预测因素。
平均年龄为5.52岁（标准差：5.54），平均住院时间（LOS）为6.37天（标准差：10.18），平均总费用为60,996.61美元（标准差：107,798.41）。有既往气管切开术的患者内镜检查和气管插管的发生率低于无气管切开术的患者（p < 0.0005）。基于既往气管切开术状态，两组之间的住院时间（p = 0.076）或总费用（p = 0.210）无显著差异。
小儿气管炎应根据气管切开术状态进行区分。我们建议气管炎诊断代码应根据是否存在气管切开术分为“开放型”（有气管切开术）和“封闭型”（无气管切开术）。
