Estimations of Laryngotracheal Stenosis After Mechanical Ventilation: A Cross‐Sectional Analysis

<jats:sec><jats:title>Objectives/Hypothesis</jats:title><jats:p>To estimate the incidence of laryngotracheal stenosis among adults after intubation.</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>Cross‐sectional analysis.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We used the Nationwide Readmission Database to examine adult patients readmitted within 45 days after admission for mechanical ventilation. Those with a diagnosis of laryngotracheal stenosis or tracheostomy dependence on their index admission were excluded. Patient demographics, associated comorbidities, and intubation lengths were compared among those with and without a diagnosis of airway stenosis at readmission.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>An estimated 624,918 patients met inclusion with a mean age of 59 years (standard error = 0.2). There were 1,230 patients readmitted within 45 days and diagnosed with laryngeal (N = 362) or tracheal stenosis (N = 920) estimating an incidence of 1.98 per 1,000 discharges. Compared with those without a diagnosis of airway stenosis, those with stenosis were younger (57 vs. 59 years, <jats:italic>P</jats:italic> < .001), more often female (62% vs. 45%, <jats:italic>P</jats:italic> < .001) and frequently intubated for >96 hours (47% vs. 32%, <jats:italic>P</jats:italic> < .001). Additionally, a history of respiratory failure, pneumonia, obesity, gastroesophageal reflux disease, and chronic steroid use were also more common among patients with stenosis. Multiple logistic regression analysis identified a decreased risk of stenosis with advancing age while an increased risk was associated strongest for females (odds ratio [OR]: 1.96, 95% confidence interval [CI]: 1.58–2.44, <jats:italic>P</jats:italic> < .001) and those with chronic steroid use (OR: 2.69, 95% CI: 1.80–4.02, <jats:italic>P</jats:italic> < .001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The incidence of laryngotracheal stenosis after intubation in adults is rare but is associated with female gender and younger age.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence</jats:title><jats:p>NA <jats:italic>Laryngoscope</jats:italic>, 132:1723–1728, 2022</jats:p></jats:sec>