新生儿反流病和先天性喉头水肿：儿童住院病人数据库分析

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY Laryngoscope Investigative Otolaryngology Pub Date : 2024-11-07 DOI:10.1002/lio2.70031

Vraj P. Shah MD, Aman M. Patel BS, Praneet C. Kaki BS, Arsany Yassa BA, Andrey Filimonov MD, PharmD

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引用次数: 0

摘要

目的：先天性喉鸣症（CLM）是导致新生儿呼吸困难的最常见原因，通常与胃食管反流和新生儿食管反流等反流性疾病（RD）有关。本研究调查了RD对患有CLM的新生儿的管理和预后的影响：对2016年儿童住院患者数据库（KID）中患有CLM（ICD-10：Q31.5）的新生儿进行了查询。通过ICD-10编码确定了RD状态、手术和并发症。通过单变量和多变量分析确定统计关联：在2212名被确认患有CLM的新生儿中，585人（26.45%）患有RD。RD患者多为女性（p = .038）、早产儿（p p p p p p p p p p p p = .088）和死亡率（OR 1.084，95% CI 0.397-2.646，p = .874）：结论：CLM 是新生儿的常见诊断，与 RD 相关。结论：CLM是新生儿的常见诊断，与RD相关。在我们的CLM新生儿队列中，RD新生儿的总体预后较差：4.

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

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).