The comorbidities and risk factors in children with congenital airway anomalies: A nationwide population-based study in Taiwan

The comorbidities and risk factors associated with congenital airway anomalies (CAAs) in children are undecided. This study aimed to investigate the comorbidities commonly associated with CAA and to explore the prognosis and risk factors in CAA children. This nationwide, population-based cohort study was conducted between 2000 and 2011 with children aged 0 to 5 years assigned to either a CAA group (6341 patients) that diagnosed with CAA or an age- and gender-matched control group (25,159 patients) without CAA, using the Taiwan National Health Insurance Research Database (NHIRD). Descriptive, logistic regression, Kaplan–Meier, and Cox regression analyses were used for the investigation. Cleft lip/palate (adjusted odds ratio [aOR], 7.88; 95% confidence interval [CI], 6.49–9.59), chromosome (aOR, 6.85; 95% CI, 5.03–9.34), and congenital neurologic (aOR, 5.52; 95% CI, 4.45–6.87) anomalies were the comorbidities most highly associated with CAA. Of the 31,500 eligible study patients, 636 (399 in the CAA group and 237 in the control group) died during the follow-up period (6.3% vs 0.9%, P < .001). The mortality risk after adjusting for age, gender, and comorbidities elevated significantly among CAA patients (adjusted hazard ratio [aHR], 4.59; 95% CI, 3.85–5.48). The need for tracheostomy (aHR, 2.98; 95% CI, 2.15–4.15), comorbidity with congenital heart disease (CHD) (aHR, 2.52; 95% CI, 2.05–3.10), and chromosome anomaly (aHR, 2.34; 95% CI, 1.70–3.23) were the independent risk factors most greatly related to CAA mortality. This study demonstrated that CAA was most highly associated with the comorbidities as cleft lip/palate, chromosome, and congenital neurologic anomalies. The CAA children had a significantly elevated mortality risk; the need for tracheostomy, CHD, and chromosome anomaly were the most related risk factors of mortality for CAA. Further studies are warranted to clarify the involved mechanisms.