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Factors and Economic Outcomes Associated with Documented Difficult Intubation in the United States

Authors Moucharite MA, Zhang J, Giffin R

Received 29 January 2021

Accepted for publication 12 March 2021

Published 1 April 2021 Volume 2021:13 Pages 227—239


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Giorgio Lorenzo Colombo

Marilyn A Moucharite, Jianying Zhang, Robert Giffin

Healthcare Economics Outcomes Research, Medtronic, Mansfield, MA, USA

Correspondence: Marilyn A Moucharite
Medtronic, 15 Hampshire Street, Mansfield, MA, 02048, USA
Tel +1 774-284-5248
Email [email protected]

Purpose: Establishing good mechanical ventilation is a critical component and prerequisite to a wide range of surgical and medical interventions. Yet difficulties in intubating patients, and a variety of associated complications, are well documented. The economic burden resulting from difficult intubation (DI), however, is not well understood. The current study examines the economic burden of documented DI during inpatient surgical admissions and explores factors that are associated with DI.
Patients and Methods: Using data from the Premier Healthcare Database, adult patients with inpatient surgical admissions between January 1, 2016 and December 31, 2018 were selected. International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) diagnosis codes were used to classify the patients into matched cohorts of DI and non-DI patients.
Results: Patients in the DI group have mean inpatient costs and intensive care unit (ICU) costs that are substantially higher than patients without difficult intubations ($14,468 and $4,029 higher, respectively). Mean hospital length of stay and ICU length of stay were 3.8 days and 2.0 days longer, respectively (all p< 0.0001, except ICU cost p=0.0001) in the DI group. Obesity, other chronic conditions, and larger hospital size were significantly associated with DI.
Conclusion: DI is associated with higher average cost and longer average length of stay.

Keywords: cost burden, difficult intubation, airway management, health economics

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