Predictors of Recurrent Croup: The Role of Social Determinants of Health and Otolaryngology Evaluation

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Abstract Objective To evaluate the influence of patient comorbidities, social determinants of health (SDOH), and otolaryngology (OTO) referral timing on disease course and healthcare utilization among pediatric patients with recurrent croup. Study Design Retrospective cohort study. Setting Large tertiary children's hospital. Methods Pediatric patients (0‐18 years) evaluated by an OTO for recurrent croup between 2011 and 2024 were included (n = 70). Demographic, clinical, and referral data were obtained from medical records. SDOH were quantified using state‐standardized Childhood Opportunity Index (COI) 3.0 scores across 3 domains and 14 subdomains. Associations between comorbidities, SDOH, and referral timing with disease duration, number of emergency department (ED) visits, corticosteroid prescriptions, and age at resolution were analyzed using t ‐tests and correlation coefficients ( α = 0.05). Results Household tobacco exposure and gastroesophageal reflux disease were associated with earlier croup onset ( P < .05). Higher Wealth, Health Resource, and Educational Resource scores correlated with shorter disease duration, fewer ED visits, and younger age at resolution ( P < .05). Shorter intervals from first ED visit to OTO evaluation correlated with fewer ED visits ( r = 0.28, P < .02), fewer corticosteroid prescriptions ( r = 0.28, P < .02), and shorter disease duration ( r = 0.51, P < .0001). Conclusion Early otolaryngology involvement and favorable SDOH—particularly wealth, health, and educational resources—were associated with improved outcomes in recurrent croup. These findings highlight opportunities for targeted counseling, timely referral, and community‐based interventions to reduce healthcare burden and enhance pediatric airway care. Level of Evidence III.