Predictors of prolonged stay after laryngeal surgery for benign neoplasms in children.

Background: Pediatric benign laryngeal tumors can often be treated as same-day surgeries. This study identified factors associated with prolonged hospital stay in children undergoing laryngeal surgery for benign tumors.

Methods: A retrospective analysis of records of pediatric patients who underwent laryngeal surgery with a post-op diagnosis of benign tumor was performed with the American College of Surgeons Pediatric National Surgery Quality Improvement Program (ACS-NSQIP-P) database (2014-2018). Clinical variables analyzed included comorbidities, total length of stay (LOS), readmission, and reoperation.

Results: 1775 patients were identified with a mean age at time of surgery of 8.95 years (95% CI 8.76-9.14). 966 (54.4%) were males and 809 (45.6%) were females. Mean LOS was 0.22 days (95% CI 0.12-0.32). Only 128 (7.3%) patients had a LOS of one day or more. Children with a variety of comorbidities, including premature birth, oxygen support, tracheostomy, developmental delay, and cardiac risk factors, had a significantly prolonged LOS (P < .001). Additionally, younger children were significantly more likely to stay overnight (β = -0.041, P < .001). Twenty-three (1.3%) patients were readmitted, 2 (0.1%) were reintubated, and 13 (0.7%) underwent reoperation for related reasons. Despite the association of premature birth, ventilator dependence, oxygen support, tracheostomy, esophageal/GI disease, developmental delay, seizure, neuromuscular disorders, congenital malformations, and steroid use with LOS, only younger age and ventilator dependence were associated with readmission.

Conclusion: This study suggests that laryngeal surgery for benign tumors is safe but recognizes that patients with comorbidities or young children may require a prolonged stay. Awareness of these implications may help guide management.