(A736) Social Determinants of Health in Predicting Severity and Treatment Course of Iatrogenic Tracheal Stenosis

Introduction: Social determinants of health (SDH) describe demographic and socioeconomic factors that can influence health status. While prolonged intubation is the common etiology for iatrogenic tracheal stenosis (TS), factors that influence stenosis severity and outcomes, particularly SDH, have been poorly studied. This study investigates a variety of SDH relationships with the severity of stenosis, frequency of tracheal dilations, and eventual decannulation.

Methods: A retrospective chart review of subjects who had prolonged intubation and a diagnosis of TS between the years of 2017 and 2023 was performed. Demographics, socioeconomic factors, stenosis severity, and treatment course were collected. Subjects were classified as having 100% TS vs. not and being decannulated vs. persistent tracheostomy dependence. Tracheal dilation frequency per year was also calculated. Logistic and linear regression statistical analysis was performed using JASP with statistical significance of p=.05.

Results: 52 patients met inclusion criteria. Hispanic ethnicity was significantly associated with having 100% TS compared to all other races (OR=18.18, p<.01]), while uninsured status had a positive but insignificant association (OR= 7.018, p= .12]). Asian race (p <.01) and uninsured status (p=.024) were both significantly associated with having more frequent dilations, while Hispanic ethnicity had a positive but insignificant association (p=.325). Having private insurance was significantly associated with eventual decannulation (p=.049).

Conclusions: Race, ethnicity, and insurance status are significantly associated with the severity of TS, treatment frequency, and tracheostomy dependence. While Asian patients received more dilations, Hispanic patients had overall worse TS severity. Uninsured patients required more frequent dilations, and privately insured patients were more likely to be decannulated. SDH have significant impact on treatment and prognosis in those with TS, and physicians should be aware of these disparities when treating their patients.