Najjar Alex, Kim Jenny, Chorney Stephen, Kou Yann-Fuu, Wang Cynthia, Johnson Romaine F
Department of Otolaryngology-Head and Neck Surgery University of Texas Southwestern Medical Center Dallas Texas USA.
Department of Pediatric Otolaryngology Children's Health Dallas Texas USA.
Laryngoscope Investig Otolaryngol. 2025 May 24;10(3):e70168. doi: 10.1002/lio2.70168. eCollection 2025 Jun.
To determine pediatric tracheostomy outcomes by social capital as measured through economic connectedness (EC).
A retrospective cohort of patients (< 18 years) who underwent tracheostomy at a tertiary pediatric hospital between 2009 and 2020 was divided into high and low socioeconomic status (SES) groups based on their neighborhood-level EC. This metric of social capital determines the degree to which an individual is connected to families of higher SES based on zip code. Regression analysis determined associations between EC and adverse outcomes, decannulation, and mortality.
A total of 527 patients were included, with 79 (15%) having higher EC and 448 (85%) having lower EC. The groups had similar medical complexity and comorbidities, and EC was found to correlate with other metrics of SES including poverty rate and area deprivation index (ADI) by zip code ( < 0.001). Patients with low EC were more likely to be discharged to an outside facility than high EC patients (9.3% vs. 3.8%, = 0.04). Outcome analysis revealed no significant differences in decannulation (22% vs. 32%, = 0.07), mortality (22% vs. 21%, = 0.88), or readmission rate (19% vs. 19%, = 0.95).
EC does not correlate with adverse outcomes, mortality, or decannulation for pediatric tracheostomy patients. These findings suggest that EC may not be the primary component of social capital that influences perioperative challenges and long-term outcomes for pediatric tracheostomies in this study population.
通过经济联系（EC）衡量社会资本，以确定小儿气管切开术的结果。
对2009年至2020年间在一家三级儿科医院接受气管切开术的18岁以下患者进行回顾性队列研究，根据其社区层面的经济联系分为高社会经济地位（SES）组和低社会经济地位组。这种社会资本指标根据邮政编码确定个体与较高社会经济地位家庭的联系程度。回归分析确定了经济联系与不良结局、拔管和死亡率之间的关联。
共纳入527例患者，其中79例（15%）经济联系较高，448例（85%）经济联系较低。两组的医疗复杂性和合并症相似，且发现经济联系与包括邮政编码贫困率和地区贫困指数（ADI）在内的其他社会经济地位指标相关（<0.001）。经济联系低的患者比经济联系高的患者更有可能出院到外部机构（9.3%对3.8%，=0.04）。结果分析显示，在拔管（22%对32%，=0.07）、死亡率（22%对21%，=0.88）或再入院率（19%对19%，=0.95）方面没有显著差异。
经济联系与小儿气管切开术患者的不良结局、死亡率或拔管无关。这些发现表明，在本研究人群中，经济联系可能不是影响小儿气管切开术围手术期挑战和长期结局的社会资本的主要组成部分。
