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The following is a summary of “Social Determinants of Health and Timing of Tracheostomy for Severe Bronchopulmonary Dysplasia,” published in the October 2024 issue of Pediatrics by Bushroe et al.
Severe bronchopulmonary dysplasia (BPD) predominantly affects infants born before 32 weeks’ gestation, leading to significant health challenges influenced by social determinants of health (SDoH).
Researchers conducted a retrospective study assessing the association between ZIP code-level SDoH and the post-menstrual age at tracheostomy placement in infants with severe BPD.
They involved infants born at less than 32 weeks’ gestation diagnosed with severe BPD who received tracheostomies before discharge (N=877). The maternal ZIP code was linked to SDoH data from the 2021 US Census Bureau, and analyses were conducted using unadjusted and adjusted models for each SDoH marker.
The results showed that patients in the highest education groups underwent tracheostomy earlier (OR: 0.972; 95% CI: 0.947-0.997, P=0.031), while non-Hispanic Black patients received tracheostomies later compared to non-Hispanic White patients (OR: 1.026; 95% CI: 1.005-1.048, P=0.017). No significant differences were found regarding household income or unemployment rates, but male sex, small for gestational age status, and later post-menstrual age at admission were associated with later tracheostomy timing.
They concluded that education level at the ZIP code level significantly influenced the timing of tracheostomy placement in infants with severe BPD, indicating a need for further evaluation of factors affecting this decision across different medical centers.
Source: jpeds.com/article/S0022-3476(24)00482-7/abstract
