Airway Intervention in Paediatric Angioedema: A National Analysis of Clinical Predictors and Outcomes

OBJECTIVE: To characterize paediatric hospitalizations for angioedema and identify the prevalence and outcomes of airway interventions using a large national database. METHODS: We performed a cross-sectional analysis of the Kids' Inpatient Database (2003-2019), including paediatric patients (0-20 years) hospitalized with angioedema identified by ICD-9/10 codes. Outcomes included hospital length of stay (LOS), total charges, and in-hospital mortality. Multivariable logistic regression evaluated predictors of airway intervention, and comparative analyses assessed outcome differences between patients with and without airway procedures. RESULTS: Among 4238 paediatric angioedema hospitalizations, 174 (4.1%) underwent airway procedures. Compared to non-intervention cases, these patients had significantly longer LOS (median 6 vs. 2 days, p < 0.001), higher charges ($59 571 vs. $7628, p < 0.001), and higher mortality (5.8% vs. 0.15%, p < 0.001). Black (adjusted odds ratio [AOR] 5.23, 95% CI 1.56-19.30) and Hispanic race (AOR 7.83, 95% CI 1.51-44.89) were associated with higher odds of intervention, while hospitalizations in the Northeast (AOR 0.10, 95% CI 0.015-0.55) and South (AOR 0.13, 95% CI 0.03-0.49) had lower odds compared to the Midwest. CONCLUSION: Airway interventions in paediatric angioedema are rare but linked to significantly higher morbidity, mortality, and healthcare costs. Geographic and racial disparities highlight the need to explore systemic factors shaping airway management decisions.