Laryngeal Stenosis: Impact of Weekend vs Weekday Admissions on Outcomes

Introduction: Laryngeal stenosis, a diagnosis encompassing glottic, subglottic, and tracheal stenosis, can cause respiratory distress requiring prompt intervention. This study evaluates the impact of weekend versus weekday admissions on laryngeal stenosis patient outcomes, focusing on care differences based on admission day.

Methods: A retrospective analysis of 2012-2019 National Inpatient Sample laryngeal stenosis cases was conducted. Patients with a primary diagnosis of laryngeal stenosis were grouped by weekend (Saturday-Sunday) or weekday (Monday-Friday) admissions. Univariate and multivariate analyses evaluated demographics, hospital characteristics, comorbidities, dispositions, and treatments.

Results: 3,272 laryngeal stenosis cases were queried, with 90.2% weekday and 9.2% weekend admissions. No significant differences based on admission day were observed in sex, race, mortality, length of stay, cost, total charges, intubation rates, or need for tracheostomy (p > 0.05). Univariate analysis revealed that patients admitted on the weekend were more likely to be older (40.0 vs 30.27 years, p < 0.001), admitted as non-elective (p < 0.001) and had non-private insurance (p < 0.001). Multivariable analysis revealed that weekend admissions were associated with fewer surgical interventions (OR 0.602, 95% CI [0.389-0.933], p = 0.023), longer time to first procedure (OR 1.580, 95% CI [1.135-2.200], p = 0.007), and higher rates of interhospital transfers (OR 0.720, 95% CI [1.462-0.362], p = 0.019). No significant differences in patient disposition were observed.

Conclusions: Weekend admissions for laryngeal stenosis are associated with increased non-elective admissions, delayed procedures, and decreased surgical interventions. Despite delays in care, no ultimate differences in patient length of stay, mortality, or disposition were observed.