Educational Objective: At the conclusion of this presentation, the participants should be able to identify the impact of race on the management of inpatient pediatric patients with laryngomalacia.
Objectives: Laryngomalacia is a congenital anomaly involving the partial collapse of soft larynx tissue, commonly resulting in stridor. This study seeks to investigate the impact of race on the management of inpatient pediatric patients with laryngomalacia. Study Design: Retrospective database study.
Methods: The 2016 Kid's Inpatient Database was queried for pediatric inpatients with laryngomalacia (ICD-10: Q315). Patient race, as coded in the database, is defined as White, Black, Hispanic, or other. Statistical associations were determined via univariate and multivariable analyses.
Results: Of the 8,663 pediatric inpatients with laryngomalacia, 4326 (49.9%) were White, 1678 (19.4%) were Black, 1744 (20.1%) were Hispanic, and 915 (10.6%) were of another race. On univariate analysis, Black (50.4%, p<0.001) and Hispanic (40.4%, p<0.001) patients were more likely to be in the lowest income quartile compared to White patients (21.9%). On multivariable analysis, Black (mean $156,290, p=0.015) and Hispanic (mean $201,863, p<0.001) patients had greater total charges than White patients ($126,473). Additionally, Black (16.0 days, p<0.001) and Hispanic (16.0 days, p=0.008) patients had longer length of stay (LOS) than White patients (12.8 days). Although Black patients had increased odds for requiring ventilation (OR: 1.411, p<0.001), odds were similar between Hispanic and White patients (OR: 1.169, p=0.060). Mortality in Black (p=0.297) and Hispanic (p=0.554) patients was similar in comparison to White patients.
Conclusions: Racial disparities exist in the management of pediatric inpatients with laryngomalacia, with Black and Hispanic patients experiencing longer LOS and greater total charges compared to White patients.