TY - JOUR
T1 - Pediatric Tracheostomy-Related Complications
T2 - A Cross-sectional Analysis
AU - Newton, Micah
AU - Johnson, Romaine F
AU - Wynings, Erin
AU - Jaffal, Hussein
AU - Chorney, Stephen R.
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2021.
PY - 2022/8
Y1 - 2022/8
N2 - Objective: To determine the rate of tracheostomy-related complications in pediatric patients from nationally representative databases. Study Design: Cross-sectional analysis. Setting: 2016 Kids’ Inpatient Database and 2016 Nationwide Readmission Database. Methods: All pediatric tracheostomy procedures were included. Complication type, admission outcomes, and readmission rates were recorded with a logistic regression analysis to determine patient characteristics associated with complications. Results: An estimated 5309 tracheostomies were performed among pediatric patients in 2016, 8% (n = 432) of whom developed tracheostomy-related complications. This group was younger (4.7 vs 8.7 years, P <.001) and required longer hospital admissions (68.7 vs 33.2 days, P <.001) than children without tracheostomy-related complications. Mean costs ($459,324 vs $397,937, P <.001) and mean total charges ($1,573,964 vs $1,099,347, P <.001) were increased if a tracheostomy-related complication occurred. These events occurred more often in those with bronchopulmonary dysplasia (24% vs 12%, P <.001), heart disease (24% vs 12%, P =.001), gastroesophageal reflux disease (31% vs 19%, P <.001), short gestational age (24% vs 14%, P <.001), and subglottic stenosis (9.9% vs 5.4%, P =.001). The estimated 30-day readmission rate was 24% (SE, 1.7%) but did not increase after tracheostomy complications (27% vs 15%, P =.04). Tracheostomy-related complications were predicted by gastroesophageal reflux disease (odds ratio [OR], 1.50; 95% CI, 1.14-1.97; P =.004), younger age (OR, 1.12; 95% CI, 1.04-1.22; P =.002), and lengthier hospitalization (OR, 1.00; 95% CI, 1.00-1.01; P <.001) on multiple logistic regression analysis. Conclusion: Tracheostomy-related complications occur in approximately 8% of pediatric patients and are higher in younger children or those with longer admission lengths. These data have implications for benchmarking standards of posttracheostomy complications across institutions.
AB - Objective: To determine the rate of tracheostomy-related complications in pediatric patients from nationally representative databases. Study Design: Cross-sectional analysis. Setting: 2016 Kids’ Inpatient Database and 2016 Nationwide Readmission Database. Methods: All pediatric tracheostomy procedures were included. Complication type, admission outcomes, and readmission rates were recorded with a logistic regression analysis to determine patient characteristics associated with complications. Results: An estimated 5309 tracheostomies were performed among pediatric patients in 2016, 8% (n = 432) of whom developed tracheostomy-related complications. This group was younger (4.7 vs 8.7 years, P <.001) and required longer hospital admissions (68.7 vs 33.2 days, P <.001) than children without tracheostomy-related complications. Mean costs ($459,324 vs $397,937, P <.001) and mean total charges ($1,573,964 vs $1,099,347, P <.001) were increased if a tracheostomy-related complication occurred. These events occurred more often in those with bronchopulmonary dysplasia (24% vs 12%, P <.001), heart disease (24% vs 12%, P =.001), gastroesophageal reflux disease (31% vs 19%, P <.001), short gestational age (24% vs 14%, P <.001), and subglottic stenosis (9.9% vs 5.4%, P =.001). The estimated 30-day readmission rate was 24% (SE, 1.7%) but did not increase after tracheostomy complications (27% vs 15%, P =.04). Tracheostomy-related complications were predicted by gastroesophageal reflux disease (odds ratio [OR], 1.50; 95% CI, 1.14-1.97; P =.004), younger age (OR, 1.12; 95% CI, 1.04-1.22; P =.002), and lengthier hospitalization (OR, 1.00; 95% CI, 1.00-1.01; P <.001) on multiple logistic regression analysis. Conclusion: Tracheostomy-related complications occur in approximately 8% of pediatric patients and are higher in younger children or those with longer admission lengths. These data have implications for benchmarking standards of posttracheostomy complications across institutions.
KW - patient safety and quality improvement
KW - pediatric tracheostomy
KW - tracheostomy outcomes
KW - tracheostomy-related complications
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U2 - 10.1177/01945998211046527
DO - 10.1177/01945998211046527
M3 - Article
C2 - 34520273
AN - SCOPUS:85135419165
SN - 0194-5998
VL - 167
SP - 359
EP - 365
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 2
ER -