Pediatric Tracheostomy-Related Complications: A Cross-sectional Analysis

Micah Newton, Romaine F Johnson, Erin Wynings, Hussein Jaffal, Stephen R. Chorney

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)359-365
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Issue number2
StatePublished - Aug 2022


  • patient safety and quality improvement
  • pediatric tracheostomy
  • tracheostomy outcomes
  • tracheostomy-related complications

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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