Carr Michele M, Ramadan Jad, Bauer Emma
University at Buffalo, Buffalo, NY, USA.
West Virginia University, Morgantown, WV, USA.
Clin Pediatr (Phila). 2020 Jun;59(7):679-685. doi: 10.1177/0009922820908917. Epub 2020 Feb 28.
This study evaluated the hospital course for neonates and older infants with a diagnosis of laryngomalacia (LM). Data came from the 2016 Kids' Inpatient Database of the Healthcare Cost Utilization Project. A total of 6537 children aged <1 year with a diagnosis of LM (International Classification of Diseases, 10th Revision, code Q31.5) were identified: 2212 neonates and 4325 non-neonates. Neonates had a higher mortality rate, 1.31% versus 0.72% in older infants, had more diagnoses (median 9 vs 7) and procedures (mean 85.24 vs 21.83), longer length of stay (median 10 vs 4 days), and higher total charges (median US$65 722 vs US$25 582). A total of 23.3% of neonates born during the admission and diagnosed with LM had undergone laryngoscopy. Second airway lesions were present in 12.33% of neonates and 15.77% of older infants. It appears that neonates are being discharged with a diagnosis of LM without laryngoscopy. Neonatal intensive care unit and newborn nursery policies should require visualization of the larynx prior to diagnosis of LM.
本研究评估了诊断为喉软化症（LM）的新生儿和大龄婴儿的住院病程。数据来自医疗成本和利用项目2016年儿童住院数据库。共识别出6537名年龄小于1岁且诊断为LM（国际疾病分类第10版，编码Q31.5）的儿童：2212名新生儿和4325名非新生儿。新生儿死亡率更高，为1.31%，而大龄婴儿为0.72%，诊断（中位数9对7）和手术（平均数85.24对21.83）更多，住院时间更长（中位数10天对4天），总费用更高（中位数65722美元对25582美元）。入院期间出生且诊断为LM的新生儿中，共有23.3%接受了喉镜检查。12.33%的新生儿和15.77%的大龄婴儿存在第二气道病变。似乎新生儿在未进行喉镜检查的情况下就被诊断为LM而出院。新生儿重症监护病房和新生儿保育室的政策应要求在诊断LM之前对喉部进行可视化检查。
