TY - JOUR
T1 - Cost analysis of intubation-related tracheal injury using a national database
AU - Bhatti, Nasir I.
AU - Mohyuddin, Atta
AU - Reaven, Nancy
AU - Funk, Susan E.
AU - Laeeq, Kulsoom
AU - Pandian, Vinciya
AU - Mirski, Marek
AU - Feller-Kopman, David
N1 - Funding Information:
Sponsorships: Study was partially funded by Covidien Healthcare under an agreement that the study be conducted independently to reduce funding bias. Accordingly, the study was designed, performed, analyzed, interpreted, and written by the investigators without the involvement, review, or prepublication approval of Covidien.
PY - 2010/7
Y1 - 2010/7
N2 - Objective: To perform risk analysis of tracheal injuries caused by endotracheal intubation (ETI) and to estimate the financial impact of these sequelae. Study Design: Cost analysis using a national database. Settings: The Agency for Healthcare Research and Quality (AHRQ) 2006 National Inpatient Sample. Subjects and Methods: We identified clinical manifestations and treatments of complications associated with endotracheal tubes and codified them into International Classification of Disease-ninth revision diagnosis and procedure codes, intentionally excluding alternative etiologies of tracheal injury. Using the AHRQ 2006 National Inpatient Sample, we then compared patients with tracheal injury coded during the medical or surgical stay for length of stay (LOS) and mean hospital cost with diagnosis-related group (DRG)-matched controls; we also examined readmissions treating tracheal injury. Results: Tracheal injury presents as tracheal stenosis, tracheomalacia, tracheoesophageal fistula, laryngotracheal ulceration, and vocal cord paralysis. A total of 3232 discharge records met criteria for tracheal injury from ETI within the index hospital stay. Average LOS for patients with tracheal injury (6.3 days; 95% confidence interval [CI] 6.0-6.3) exceeded LOS in the uncomplicated sample (5.2 days; CI 5.1-5.3) by 1.1 days. The average hospital cost was $1888 higher with tracheal injury ($10,375 [CI $9762-$10,988] vs $8487 [CI $8266-$8669]). LOS for procedures treating prior tracheal injury averaged 4.7 days and cost an average of $11,025 per discharge. Conclusion: Tracheal injury from ETI is associated with a significant increase in healthcare costs that accrue both during the index admission and during subsequent hospitalizations required to treat the injury.
AB - Objective: To perform risk analysis of tracheal injuries caused by endotracheal intubation (ETI) and to estimate the financial impact of these sequelae. Study Design: Cost analysis using a national database. Settings: The Agency for Healthcare Research and Quality (AHRQ) 2006 National Inpatient Sample. Subjects and Methods: We identified clinical manifestations and treatments of complications associated with endotracheal tubes and codified them into International Classification of Disease-ninth revision diagnosis and procedure codes, intentionally excluding alternative etiologies of tracheal injury. Using the AHRQ 2006 National Inpatient Sample, we then compared patients with tracheal injury coded during the medical or surgical stay for length of stay (LOS) and mean hospital cost with diagnosis-related group (DRG)-matched controls; we also examined readmissions treating tracheal injury. Results: Tracheal injury presents as tracheal stenosis, tracheomalacia, tracheoesophageal fistula, laryngotracheal ulceration, and vocal cord paralysis. A total of 3232 discharge records met criteria for tracheal injury from ETI within the index hospital stay. Average LOS for patients with tracheal injury (6.3 days; 95% confidence interval [CI] 6.0-6.3) exceeded LOS in the uncomplicated sample (5.2 days; CI 5.1-5.3) by 1.1 days. The average hospital cost was $1888 higher with tracheal injury ($10,375 [CI $9762-$10,988] vs $8487 [CI $8266-$8669]). LOS for procedures treating prior tracheal injury averaged 4.7 days and cost an average of $11,025 per discharge. Conclusion: Tracheal injury from ETI is associated with a significant increase in healthcare costs that accrue both during the index admission and during subsequent hospitalizations required to treat the injury.
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U2 - 10.1016/j.otohns.2009.11.004
DO - 10.1016/j.otohns.2009.11.004
M3 - Article
C2 - 20620616
AN - SCOPUS:77953753822
SN - 0194-5998
VL - 143
SP - 31
EP - 36
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
IS - 1
ER -