Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis

Abstract Objectives Congenital laryngomalacia (CLM) is the most common cause of stridor in neonates and is commonly associated with reflux disease (RD) such as gastroesophageal reflux and newborn esophageal reflux. This study investigates the impact of RD on the management and outcomes of neonates w...

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Main Authors: Vraj P. Shah, Aman M. Patel, Praneet C. Kaki, Arsany Yassa, Andrey Filimonov
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Laryngoscope Investigative Otolaryngology
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Online Access:https://doi.org/10.1002/lio2.70031
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author Vraj P. Shah
Aman M. Patel
Praneet C. Kaki
Arsany Yassa
Andrey Filimonov
author_facet Vraj P. Shah
Aman M. Patel
Praneet C. Kaki
Arsany Yassa
Andrey Filimonov
author_sort Vraj P. Shah
collection DOAJ
description Abstract Objectives Congenital laryngomalacia (CLM) is the most common cause of stridor in neonates and is commonly associated with reflux disease (RD) such as gastroesophageal reflux and newborn esophageal reflux. This study investigates the impact of RD on the management and outcomes of neonates with CLM. Methods The 2016 Kids' Inpatient Database (KID) was queried for neonates with CLM (ICD‐10: Q31.5). RD status, procedures, and complications were identified with ICD‐10 codes. Univariate and multivariable analyses were implemented to determine statistical associations. Results Of 2212 neonates identified with CLM, 585 (26.45%) had RD. Patients with RD were more often female (p = .038) and premature (p < .001). Upon multivariable analysis, patients with RD had greater total charges (Mean $457,810.87 vs. $259,020.90, p < .001) and longer length of stay (Mean 46.03 vs. 26.44 days, p < .001). Those with RD had more diagnoses recorded (Mean 14.15 vs. 9.66, p < .001), underwent more procedures (Mean 5.47 vs. 3.49, p < .001), and had a longer wait until their first procedure (Mean 13.27 vs. 7.02 days, p < .001). Patients with RD had increased odds for undergoing laryngoscopy (OR 1.799, 95% CI 1.382–2.321, p < .001), bronchoscopy (OR 2.179, 95% CI 1.598–2.801, p < .001), and ventilator use (OR 1.526, 95% CI 1.197–1.886, p < .001) on multivariable regression adjusting for patient demographics, hospital characteristics, and comorbidities. Patients with and without RD had similar odds for undergoing tracheotomy (OR 1.540, 95% CI 0.934–2.522, p = .088) and mortality (OR 1.084, 95% CI 0.397–2.646, p = .874). Conclusion CLM is a common diagnosis in neonates that is associated with RD. In our cohort of neonates with CLM, those with RD had overall poorer outcomes. Level of evidence 4.
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spelling doaj-art-be5635a474df4e4b8cb13cde3fa188e72024-12-23T11:50:35ZengWileyLaryngoscope Investigative Otolaryngology2378-80382024-12-0196n/an/a10.1002/lio2.70031Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysisVraj P. Shah0Aman M. Patel1Praneet C. Kaki2Arsany Yassa3Andrey Filimonov4Department of Otolaryngology–Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USADepartment of Otolaryngology–Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USADepartment of Otolaryngology–Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USADepartment of Otolaryngology–Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USADepartment of Otolaryngology–Head and Neck Surgery Rutgers New Jersey Medical School Newark New Jersey USAAbstract Objectives Congenital laryngomalacia (CLM) is the most common cause of stridor in neonates and is commonly associated with reflux disease (RD) such as gastroesophageal reflux and newborn esophageal reflux. This study investigates the impact of RD on the management and outcomes of neonates with CLM. Methods The 2016 Kids' Inpatient Database (KID) was queried for neonates with CLM (ICD‐10: Q31.5). RD status, procedures, and complications were identified with ICD‐10 codes. Univariate and multivariable analyses were implemented to determine statistical associations. Results Of 2212 neonates identified with CLM, 585 (26.45%) had RD. Patients with RD were more often female (p = .038) and premature (p < .001). Upon multivariable analysis, patients with RD had greater total charges (Mean $457,810.87 vs. $259,020.90, p < .001) and longer length of stay (Mean 46.03 vs. 26.44 days, p < .001). Those with RD had more diagnoses recorded (Mean 14.15 vs. 9.66, p < .001), underwent more procedures (Mean 5.47 vs. 3.49, p < .001), and had a longer wait until their first procedure (Mean 13.27 vs. 7.02 days, p < .001). Patients with RD had increased odds for undergoing laryngoscopy (OR 1.799, 95% CI 1.382–2.321, p < .001), bronchoscopy (OR 2.179, 95% CI 1.598–2.801, p < .001), and ventilator use (OR 1.526, 95% CI 1.197–1.886, p < .001) on multivariable regression adjusting for patient demographics, hospital characteristics, and comorbidities. Patients with and without RD had similar odds for undergoing tracheotomy (OR 1.540, 95% CI 0.934–2.522, p = .088) and mortality (OR 1.084, 95% CI 0.397–2.646, p = .874). Conclusion CLM is a common diagnosis in neonates that is associated with RD. In our cohort of neonates with CLM, those with RD had overall poorer outcomes. Level of evidence 4.https://doi.org/10.1002/lio2.70031congenital laryngomalaciahead and neck surgeryneonatepediatricreflux disease
spellingShingle Vraj P. Shah
Aman M. Patel
Praneet C. Kaki
Arsany Yassa
Andrey Filimonov
Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis
Laryngoscope Investigative Otolaryngology
congenital laryngomalacia
head and neck surgery
neonate
pediatric
reflux disease
title Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis
title_full Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis
title_fullStr Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis
title_full_unstemmed Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis
title_short Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis
title_sort reflux disease and congenital laryngomalacia in neonates a kids inpatient database analysis
topic congenital laryngomalacia
head and neck surgery
neonate
pediatric
reflux disease
url https://doi.org/10.1002/lio2.70031
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