The objective of this study was to determine temporal trends of dysphagia diagnoses in hospitalized children. This is a retrospective observational study from the 1997-2012 Kids' Inpatient Database (KID) conducted in the setting of weighted hospitalizations in a KID participating center. More than 6 million pediatric admissions were captured in each triennial KID report. Main outcomes included triennial rates of dysphagia diagnosis in hospitalized pediatric patients, and secondary outcomes included rates of dysphagia in premature and low-birthweight infants. Dysphagia diagnoses were coded in 5107/6607653 (0.08%) of these admissions in 1997, rising to 27,464/6,675,222 (0.41%) in 2012 (p < 0.001). The portion of these diagnoses in premature neonates has been increasing over time from 162/9551 (1.7%) in 2003 to 1027/27,464 (3.7%) by 2012 (p < 0.001). Similarly, low-birthweight children constituted 40/5107 (0.8%) of dysphagia diagnoses in 1997, a number that increased to 762/27,464 (2.8%) in 2012. Rates of dysphagia are increasing nationally, particularly in premature and low-birthweight infants, which may represent an increase alongside other neuroanatomic abnormalities. This growing problem illustrates the need for better data on the comparative efficacy of diagnostic and treatment modalities.

2c. Laryngoscope, 1963-1969, 2018.

No abstract

The authors sought to compare hospital utilization and complications in patients undergoing pharyngeal flap (PF) or sphincter pharyngoplasty (SP) for velopharyngeal insufficiency (VPI). A retrospective analysis of the 2014 and 2015 American College of Surgeons National Surgical Quality Improvement Project-Pediatrics (ACS NSQIP-P) was performed. Current procedural terminology codes were used to identify children undergoing PF (42225, 42226) and SP (42950) for VPI (International Classification of Diseases version 9: 478.29, 528.9, or 750.29). Four hundred forty-six patients were treated for VPI with either PF (n = 250) or SP (n = 196). The groups were demographically similar in age, gender, race, and preoperative comorbidity. Pharyngeal flap was performed less often as an outpatient procedure than SP (96/250 [38.4%] vs 130/196 [66.3%], P < 0.0001) and had a longer total length of hospital stay (mean 1.76 ± 1.29 vs 0.98 ± 0.91 days, P < 0.0001). No difference in total complications (10/250 [4.0%] vs 3/196 [1.5%], P = 0.124) was identified. The reduction in hospital resource utilization (fewer admissions, shorter length of stay) is notable. No difference in complications was identified between the 2 procedures.