Healthcare disparities for the development of airway stenosis from the medical intensive care unit

Clayton Prakash Burruss, Robin B. Pappal, Michael A. Witt, Christopher Harryman, Syed Z. Ali, Matthew L. Bush, Mark A. Fritz

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives/hypothesis: To identify sociodemographic factors associated with the development of airway stenosis (AS) among intubated medical intensive care unit (MICU) patients. Study design: Retrospective cohort study. Methods: A retrospective review of adult MICU intubated patients from 2013 to 2019 at a single academic institution was performed. Univariate and multivariate analysis with logistic regression examined associations between the development of AS and subsite abnormalities such as posterior glottic stenosis (PGS), subglottic stenosis (SGS), tracheal stenosis (TS), vocal fold immobility (VFI), and posterior glottic granuloma (PGG) with age, body mass index (BMI), height, weight, race, ethnicity, sex, rurality, Appalachian status, length of admission, distance to hospital, and median household income. Results: Of an overall sample of 6603 MICU patients, 449 intubated patients were included in the study, and 204 patients were found to have AS. AS was statistically associated with decreased driving distance to the hospital and increases in BMI. PGS was statistically associated with increases in age. TS was statistically associated with increases in admission duration and not having residence status in Appalachia. VFI was statistically associated with decreases in driving distance to the hospital and not having residence status in Appalachia. Additionally, black patients had a higher odds of developing VFI compared to Caucasian patients. Conclusion: AS is associated with sociodemographic factors such as age, BMI, shorter distance to hospital, admission duration, and no Appalachian status. These data demonstrate the need to further investigate the impact of social determinants of health on airway pathology and outcomes. Level of evidence: 4.

Original languageEnglish
Pages (from-to)1078-1086
Number of pages9
JournalLaryngoscope investigative otolaryngology
Issue number4
StatePublished - Aug 2022

Bibliographical note

Funding Information:
We would like to acknowledge the late Dr. Kunwar Prasad Bhatnagar, PhD, Professor Emeritus of Anatomical Sciences and Neurobiology at the University of Louisville School of Medicine, and grandfather of author Clayton P. Burruss, for his intellectual guidance and support throughout the research process.

Funding Information:
Matthew L. Bush is a consultant for MED‐EL and Stryker and has received research funding from Advanced Bionics (unrelated to this research). There are no conflicts of interests with the content of this manuscript. The authors have no other financial relationships or conflicts of interest to disclose pertaining to the manuscript. Matthew L. Bush, associate editor of the journal, had no role in the editorial review of or decision to publish this article.

Funding Information:
The project described was supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funding organizations had no input into the content of this manuscript.

Publisher Copyright:
© 2022 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.


  • airway stenosis
  • glottic stenosis
  • healthcare access
  • healthcare disparities
  • tracheal stenosis

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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