Does influenza vaccination or RSV prophylaxis impact resource utilization for children after the diagnosis of airway disorders?

OBJECTIVE: Quantify the rates influenza vaccination and RSV prophylaxis for children with airway stenosis and/or other disorders and assess impact on resource utilization. METHODS: This was a retrospective study with data extracted from Duke Enterprise Data Unified Content Explorer (DEDUCE) between January 1, 2006 and December 1, 2017. Children aged 18 years and younger with at least one diagnosis code for airway stenosis and/or disorders were included. The index date was defined as the first date of airway stenosis/disorders diagnosis. Each patient was followed for up to one year after the index date. Influenza vaccination or RSV prophylaxis documented within one year of index date were included. We defined emergency department (ED) visits and/or hospital admissions related to respiratory diagnoses as the primary outcome of increased resource utilization. RESULTS: A total of 2718 patients were included. In our institution, our results have indicated that there are fairly low vaccination documentation rates of influenza vaccination, RSV prophylaxis, or both provided to children with airway stenosis/disorders, 14.1% (389/2718), 1.1% (30/2718), and 0.6% (17/2718), respectively, within the first year after diagnosis. Around 5% (139/2718) and 10% (269/2718) experienced ED visits or hospitalizations related to respiratory issues within the first year after diagnosis, respectively. Among 139 and 269 patients with ED visits or hospitalizations, 34 (25%) and 54 (20%) had multiple visits, respectively. Very few patients had documented influenza vaccination (11/139, 0.4%) or RSV prophylaxis (5/269, 0.18%) before ED visits or hospitalization. CONCLUSIONS: There is little available evidence at this time for strategies to prevent adverse events or complications in children with airway stenosis/disorders. In our institution, our results have indicated that there are fairly low documented rates of influenza vaccination, RSV prophylaxis, or both provided to children with airway stenosis/disorders in the first year after diagnosis. This is an area of significant clinical interest for potentially limiting adverse events and optimizing resource utilization for children with airway stenosis/disorders.

Duke Scholars

Author Jeffrey Cheng Pediatric Otolaryngology

Author Hui-Jie Lee