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Updated: Feb 16, 2026
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Revisits after pediatric tracheotomy: Airway concerns result in returns
Sophie Shay1, Nina L Shapiro1, Neil Bhattacharyya2
1Department of Head and Neck Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Insights
Pediatric tracheotomy patients have a high 30-day hospital revisit rate, especially within 48 hours post-discharge, often due to tracheotomy tube issues or respiratory problems. Improved discharge planning is crucial to prevent these revisits.
Area of Science:
- Pediatric Surgery
- Healthcare Quality Improvement
- Patient Safety
Background:
- Children undergoing tracheotomy are a vulnerable patient group.
- Understanding hospital revisits after pediatric tracheotomy is vital for enhancing care quality.
Purpose of the Study:
- To investigate the incidence and characteristics of hospital revisits within 30 days following pediatric tracheotomy.
Main Methods:
- A population-based study analyzed state inpatient and emergency department databases from 2010-2011.
- Data included pediatric tracheotomy cases (<18 years) and subsequent 30-day post-discharge revisits.
- Demographic data, revisit rates, diagnoses, procedures, and discharge dispositions were analyzed.
Main Results:
- The 30-day revisit rate was 16.6% (373/2248 cases), with 34.3% occurring within 48 hours of discharge.
- Common revisit diagnoses included device adjustment (25.7%), respiratory failure (11.0%), and pneumonia (4.0%).
- Children discharged to skilled care facilities had higher revisit rates (23.3%) than those discharged home (12.0%).
Conclusions:
- Pediatric tracheotomy patients exhibit a significant 30-day revisit rate, particularly in the early post-discharge period.
- Tracheotomy tube complications and pulmonary issues are primary drivers of revisits.
- Enhanced discharge planning is recommended to mitigate these common complications and improve patient outcomes.
Objectives:
Children undergoing tracheotomy represent a medically vulnerable patient population, and understanding the reasons for revisiting the hospital setting following tracheotomy is critical for improving the quality of care for these patients. This study aims to investigate the incidence and characteristics of revisits following pediatric tracheotomy.
Methods:
Cross-sectional, population-based study using state databases. The State Inpatient Databases and State Emergency Department Databases for California, Florida, Iowa and New York 2010-11 were linked and examined for cases of pediatric tracheotomy (patients < 18.0 years) and corresponding subsequent 30-day post-discharge revisits. Demographic and descriptive data were analyzed determining the revisit rate, revisit diagnoses, procedures, and discharge dispositions.
Results:
2,248 pediatric tracheotomy cases were extracted (60.8% male, mean age 8.3 years). There were 373 inpatient or emergency department revisits (30-day revisit rate, 16.6%), of which 34.3% occurred within 48 h after discharge. Of these, 59.2% were inpatient readmissions. There were ≤10 deaths during these revisits (30-day revisit mortality rate, ≤2.7%). The most common primary revisit diagnoses were "fitting of prosthesis and adjustment of devices" (25.7%, likely representing adjustment/replacement of the tracheotomy tube), respiratory failure (11.0%), intracranial injury (5.4%), pneumonia (4.0%), "other upper respiratory disease" (3.8%), and "complications of surgical procedures or medical care" (3.8%). The most common revisit procedures were endotracheal intubation (11.4%), mechanical ventilation (8.8%), and replacement of tracheostomy tube (≤2.7%). Children discharged to a skilled care facility (47.1%) were more likely than those discharged to home (52.9%) to have a revisit (23.3% versus 12.0%, respectively; p < 0.001).
Conclusions:
Children undergoing tracheotomy have a substantial 30-day revisit rate, most notably during the first 48 h after discharge, often involving tracheotomy tube or pulmonary complications. Improvements in discharge planning should target prevention of these complications.
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