Neighborhood Socioeconomic Disadvantage and Long-Term Outcomes After Pediatric Tracheostomy.

Autor: Mitchell DN; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A., Beams DR; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A., Chorney SR; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.; Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, U.S.A., Kou YF; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.; Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, U.S.A., Liu P; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A., Dabbous H; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A., Johnson RF; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.; Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, U.S.A.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2024 May; Vol. 134 (5), pp. 2415-2421. Date of Electronic Publication: 2023 Oct 18.
DOI: 10.1002/lary.31117
Abstrakt: Objectives: To determine whether long-term outcomes after pediatric tracheostomy are impacted by neighborhood socioeconomic disadvantage.
Methods: A prospective cohort of children with tracheostomies was followed at an academic pediatric hospital between 2015 and 2020. Patients were grouped into low or high socioeconomic disadvantage using their neighborhood area deprivation index (ADI). Survival and logistic regression analyses determined the relationship between ADI group, decannulation, and mortality.
Results: A total of 260 children were included with a median age at tracheostomy of 6.6 months (interquartile range [IQR], 3.9-42.3). The cohort was 53% male (N = 138), 55% White race (N = 143), and 35% Black or African American (N = 90). Tracheostomy was most frequently indicated for respiratory failure (N = 189, 73%). High neighborhood socioeconomic disadvantage was noted for 66% of children (N = 172) and 61% (N = 158) had severe neurocognitive disability. ADI was not associated with time to decannulation (HR = 0.90, 95% confidence interval [95% CI]: 0.53-1.53) or time to death (HR = 0.92, 95% CI: 0.49-1.72).
Conclusions: Neighborhood socioeconomic disadvantage was not associated with decannulation or mortality among children with a tracheostomy. These findings suggest that long-term outcomes after pediatric tracheostomy are less dependent on socioeconomic factors in an individual community.
Level of Evidence: 3 Laryngoscope, 134:2415-2421, 2024.
(© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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